Nasal irrigation with Zatoxin Rinse in postoperative care

Abstract

Aim: The aim of this study was to assess the effect of nasal irrigation with isotonic sodium chloride and sodium bicarbonate solution in the form of Zatoxin Rinse kit on the process of postopera-tive wound healing and resolution of inflammation in patients who undergo surgery of the nasal cavity or paranasal sinuses. Moreover, our study also compared the effectiveness of na-sal irrigation with Zatoxin Rinse kit to the use of saline spray, when applied for 4 weeks after nasal septum surgery. Material and methods: Multicenter observational studies were conducted with the use of a questionnaire which was filledout on two consecutive visits, scheduled with a 1-month interval. These questionnaires applied to patients who underwent endoscopic surgical intervention in the nasal cavity and paranasal sinuses and were therefore qualified for this study. The study group included 71 patients (mean age: 42.87 ± 13.22 years; 29 female and 42 male) suffering from the following disorders: chronic rhinosinusitis (CRS) with polyps, n = 25; CRS without polyps, n = 19; de-viated septum, n = 27. The control group included 7 patients with deviated septum (using saline nasal products/seawater spray). Based on the questionnaire results and ENT examina-tion, the severity of inflammation and effectiveness of wound healing were assessed with the use of: SNOT-22 (sino-nasal outcome score), Visual Analogue Scale (VAS) and endoscopic examination of nasal cavities. Results: The median value for results obtained from the SNOT-22 questionnaire was 38 points (IQR = 36) in CRS without polyps, 33 points (IQR = 24) in CRS with polyps and 26 points (IQR = 19) in deviated septum. The median values for all scores recorded in specific subgroups after 4 weeks of applying Zatoxin Rinse were as follows: patients with CRS with polyps: 7 points (IQR = 9.5), patients with CRS without polyps: 5 points (IQR = 13), patients with deviated septum: 6 points (IQR = 9). Postoperative nasal discharge was observed to be the most fre-quent in patients with CRS: among patients suffering from CRS with polyps, the median VAS scale result was 6 points (IQR = 4), while the median for patients diagnosed with CRS without polyps was 6 points (IQR = 5) and 3 points (IQR = 4) in the group with deviated septum. The feeling of impaired nasal patency in the postoperative period was reported to be the strongest in patients diagnosed with CRS without polyps: 8 points (IQR = 5), as com-pared to 5 points (IQR = 4.5) in patients with CRS with polyps and 5 points (IQR = 7) in the deviated septum group. Postoperative smell disorders were observed to be expressed as more severe among patients with CRS without polyps: 6 points (IQR = 4) and less severe in pa-tients with CRS with polyps: 4 points (IQR = 7). After 4 weeks of healing aided by irrigation of paranasal sinuses with the use of Zatoxin Rinse kit, patients from all subgroups experienced a statistically significant reduction in the severity of all parameters assessed by the VAS scale. In the endoscopic assessment of nasal cavities with the use of Lund-Kennedy scoring system, conducted prior to irrigating nasal cavities with the Zatoxin Rinse kit, the highest results were recorded in patients diagnosed with CRS with polyps: 10 points (IQR = 9.5), as compared to 8 points (IQR = 6) in patients with CRS without polyps and 6 points (IQR = 5) in patients with deviated septum. After 4 weeks, the median result in CRS with polyps group was 3 points (IQR = 3.5), while the CRS without polyps and deviated septum groups recorded the same median result of 3 points (IQR = 3). Conclusions: (1) Nasal irrigation with Zatoxin Rinse is characterized by good tolerability and is easy to per-form. No adverse effects of nasal irrigation were identified among 71 examined individuals and patients were satisfied with the application method provided by the Zatoxin Rinse kit; (2) Zatoxin Rinse promotes healing of postoperative wounds in patients who undergo surgical intervention in the paranasal sinuses or in the nasal septum, as compared to the use of saline spray.