Rinse to Relief: Meta-Analysis on the Efficacy of Saline Irrigation to Improve Nasal Symptoms in Children with Allergic Rhinitis
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Abstract
Introduction:
Allergic rhinitis is a prevalent respiratory condition that affects 400 million people worldwide, with children accounting for over 40% of cases. Due to their developing immune systems, children are especially vulnerable. Moreover, increasing air pollution from climate change has worsened nasal symptoms, making conventional treatments like antihistamines and corticosteroids less effective. This highlights the need for safe and accessible adjuvant therapies, such as saline irrigation. However, updated meta-analyses on this issue specific to children are lacking. Thus, this research aims to assess the efficacy of saline irrigation in improving nasal symptoms of children diagnosed with allergic rhinitis.
Method:
This study was done according to the PRISMA guidelines. A comprehensive search was done through PubMed, Cochrane, ScienceDirect, and Scopus up to 20 October 2024. Review Manager 5.4.1 was used to conduct the statistical analysis, including the sensitivity analysis and funnel plot to examine heterogeneity. Cochrane Risk of Bias 2.0. was also used to assess the studies for bias.
Results and Discussion:
Five randomised controlled trials involving 268 participants were analysed quantitatively, with saline irrigation as the intervention and corticosteroid sprays or no treatments serving as controls. The primary outcome investigated is the Total Nasal Symptom Score (TNSS). Our study shows that saline irrigation more significantly decreases the nasal symptoms associated with allergic rhinitis, as indicated by a mean difference of -1.35 (95% Cl: -1.59 to -1.11, p < 0.00001) and low-moderate risk of bias. However, heterogeneity was high (I² = 100%) due to lack of participant blinding and variability of study conditions.
Conclusion:
Saline irrigation significantly reduces nasal symptoms in children with allergic rhinitis, making it a beneficial adjuvant therapy. However, high heterogeneity suggests more rigorous studies are needed. For parents, incorporating saline irrigation into their children’s daily routines can provide additional relief alongside prescribed treatments, especially in high-pollution environments.
Keywords: allergic rhinitis, children, nasal symptoms, saline irrigation
Article Details
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© Journal of Asian Medical Students’ Association (JAMSA). Released under a Creative Commons license.
References
Alnahas S, Abouammoh N, Althagafi W, Abd-Ellatif EE. Prevalence, severity, and risk factors of allergic rhinitis among schoolchildren in Saudi Arabia: A national cross-sectional study, 2019. World Allergy Organ J. 2023 Oct 10;16(10):100824.
Scadding GK, Smith PK, Blaiss M, Roberts G, Hellings PW, Gevaert P, et al. Allergic rhinitis in childhood and the new EUFOREA algorithm. Front Allergy. 2021 Jul 14;2:706589.
Li CH, Sayeau K, Ellis AK. Air pollution and allergic rhinitis: role in symptom exacerbation and strategies for management. J Asthma Allergy. 2020 Aug 26;13:285–92.
Sun W, Ding C, Jiang Z, Zheng X, Jiang J, Xu H. The impact of ambient air pollution on allergic rhinitis symptoms: a prospective follow-up study. Toxics. 2024 Sep 11;12(9):663.
Rosario CS, Urrutia-Pereira M, Murrieta-Aguttes M, D’Amato G, Chong-Silva DC, Godoi RH, et al. Air pollution and rhinitis. Front Allergy. 2024 May 28;5:1387525.
Ercan N, Demirel F, Yeşillik S, Bolat A, Kartal Ö. Efficacy of sodium hyaluronate in relieving nasal symptoms of children with intermittent allergic rhinitis: a randomized controlled trial. Eur Arch Otorhinolaryngol. 2022 Jun;279(6):2925–34.
Pingani L, Forghieri M, Ferrari S, Salvador-Carulla L, Artioli G, Gibertoni D, et al. A comparison of the recovery style and personal identity in subjects with psychosis, their relatives and mental health professionals. Int J Soc Psychiatry. 2017 Jun;63(4):362–70.
D’Antoni AV, Zarlengo K, McBride J, Boyle P. The effect of visual display of student marks on tutorial attendance and performance in the gross anatomy laboratory. Anat Sci Educ. 2009 Jul-Aug;2(4):182–6.
Kurtaran H, Uyar Y, Kasapoğlu F, Doğan M, Yıldırım İ, Kırgezen T. The impact of isotonic and hypertonic saline solutions on mucociliary activity in various nasal pathologies: clinical study. J Laryngol Otol. 2010;124(10):1035–40.
Agyemang-Yeboah F, Oppong S, Kyei-Adade S, Adjapong M, Aboagye B, Mettimano M, et al. The effect of pre-analytical factors on the performance of urine dipstick tests. Afr J Lab Med. 2019;8(1):1–8. Nuutinen J. Researcher’s Voice: Application of mathematical modeling in nasal mucociliary clearance. Procedia CIRP. 2015;37:193–8.
Wang Y, Zhang L. Role of nasal saline irrigation in treatment of allergic rhinitis in children: a systematic review and meta-analysis. Allergol Immunopathol (Madr). 2020 Mar-Apr;48(2):184–91.