A 48-year-old woman with a history of nonallergic rhinitis, asthma, and aspirin intolerance presented with worsening symptoms of nasal congestion, purulent drainage, and anosmia. On anterior rhinoscopy, nasal polyps were visualized. There was also evidence of chronic rhinosinusitis on imaging studies during work-up for another medical condition. When questioned further, she mentioned that she had experienced multiple bouts of acute exacerbations of chronic rhinosinusitis in the past 18 months and had taken antibiotics for it. The patient was unwilling to undergo a surgery to reduce polyp burden. She successfully underwent aspirin desensitization and experienced partial relief of symptoms with daily aspirin intake. Simultaneously, she was asked to use nasal saline spray for improving symptoms of chronic rhinosinusitis, which also helped her to reduce dependence on antibiotics.

Pharmacological management of rhinosinusitis involves the use of antibiotics, mucolytics, decongestants, and corticosteroids.¹ Information available from several studies also emphasizes the valuable role of saline as an adjunct therapy in chronic rhinosinusitis.^1,2 Saline acts by promoting ciliary function and reducing edema, thereby improving drainage through sinus ostia.¹

References

1. Papsin B, McTavish A. Saline nasal irrigation. Can Fam Physician 2003;49:168-173.
2. Hildenbrand T, Weber R, Heubach C, et al. Nasal douching in acute rhinosinusitis. Laryngorhinootologie. 2011 Jun;90(6):346-51.