The comparison of nasal irrigation outcome between 3% NaCl and 0.9% NaCl in adults majority with intermittent allergic rhinitis: A randomized double-blind study

Background: Management of allergic rhinitis with oral antihistamine and steroid nasal spray are the standard treatment which is recommended by Allergic Rhinitis and its Impact on Asthma guidelines. In addition, nasal irrigation as an adjuvant therapy also provides a satisfactory result. Objective: To compare the treatment outcome in adults majority with intermittent allergic rhinitis who receive different concentrations of nasal irrigation. Methods: The prospective randomized double-blind study was performed in 80 patients. All patients were prescribed oral antihistamine and nasal irrigated solution between 3% NaCl and 0.9% NaCl. Nasal congestion and rhinorrhea were evaluated at baseline, first and second weeks after treatment. Assessments were measured by nasal congestion visual analog scale rhinorrhea visual analog scale, inferior turbinate size, and peak nasal expiratory flow rate (PNEFR). A p value of < 0.05 was considered statistically significant. Results: There were 40 patients in each group of the study. Patients reported satisfactory experience after using saline irrigation at first and second weeks in both solutions (p value < 0.001). However, when compared between groups, no significant differences for all parameters were reported. PNEFR showed good results after the first week of 3% NaCl irrigation (p value = 0.001), while 0.9% NaCl had good results after the second week (p value < 0.001). Conclusion: Both add-on treatments have a significant improvement of all 4 parameters assessed in the study: nasal congestion, rhinorrhca, inferior turbinate size and PNEFR. Of note, 3% NaCl but not 0.9 NaCl had improved the PNEFR earlier from 1 week of the treatment.