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Dead Sea salt irrigations vs saline irrigations with nasal steroids for symptomatic treatment of chronic rhinosinusitis: a randomized, prospective double-blind study.
Int Forum Allergy Rhinol. 2012 May-Jun;2(3):252-7. doi: 10.1002/alr.21003. Epub 2012 Feb 15.
Friedman M, Hamilton C, Samuelson CG, Maley A, Wilson MN, Venkatesan TK, Joseph NJ. Source Department of Otolaryngology-Head and Neck Surgery, Rush University Medical Center, 30 N. Michigan Ave, Chicago, IL 60602, USA. hednnek@aol.com

Rhinosinusite chronique et solutions salées
Une alternative aux corticoïdes

Cette étude randomisée et en double-aveugle a duré quatre semaines, une durée logique pour pouvoir comparer deux traitements, l'un à base de solutions salées de la Mer Morte (rinçage et spray) et l'autre utilisant un spray corticoïde à base de fluticasone ainsi que du sérum physiologique (rinçage et spray). Les chercheurs concluent à une efficacité équivalente entre les deux traitements et montrent ainsi une nouvelle voie de traitement sans l'utilisation de corticoïdes aux effets secondaires potentiels à long terme avec notamment une dépendance.

BACKGROUND:
Intranasal steroids are 1 of the most frequently prescribed medications for the treatment of chronic rhinosinusitis (CRS), and saline irrigations are commonly used as an adjunct to medical therapy. We aimed to compare the efficacy of Dead Sea salt (DSS) irrigations and DSS nasal spray vs saline irrigations and topical nasal steroid spray in the treatment of symptoms of CRS.

METHODS:
A total of 145 symptomatic adult patients without acute infection were initially enrolled and 114 completed the study. Patients completed a Sino-Nasal Outcomes Test 20 (SNOT-20) survey (primary outcome metric) and underwent endonasal examination, acoustic rhinometry, and smell testing (secondary outcome metrics). Patients were randomized to 2 groups. The experimental group (n = 59) self-administered hypertonic DSS spray and DSS irrigation; the control group (n = 55) self-administered fluticasone spray and hypertonic saline irrigation and spray. Patients and staff were blinded to group assignment. Outcomes were reassessed at 4 weeks.

RESULTS:
The 2 groups were homogeneous with respect to pretreatment primary and secondary outcome metrics. Dropout rates were 30% in the DSS group and 36.6% in the control group. Both groups showed significant improvement in mean SNOT-20 scores following treatment; however, the degree of improvement was not significantly different between groups (p = 0.082). There were no significant changes in secondary outcome metrics between the 2 groups.

CONCLUSION:
For patients with CRS, treatment with DSS irrigations and sprays appears as effective for symptom reduction as a combination of hypertonic saline irrigations and sprays and a topical steroid spray.

Esculape : L'eau salée de la Mer Morte a-t-elle des propriétés spécifiques ?? Un spray d'eau de mer isotonique peut-elle la remplacer ? voire de l'eau douce salée au gros sel ? de Guérande ??

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