Efficacy of syringe-irrigation topical therapy and the influence of the middle turbinate in sinus penetration of solutions

Abstract Introduction: Topical therapies are the best postoperative treatment option for chronic rhinosinusitis, especially those with high volume and pressure, such as the squeeze bottles. However, they are not an available option in Brazil, where irrigation syringes are used. Objective: To inves...

Full description

Bibliographic Details
Main Authors: Guilherme Henrique Wawginiak, Leonardo Balsalobre, Eduardo Macoto Kosugi, João Paulo Mangussi-Gomes, Raul Ernesto Samaniego, Aldo Cassol Stamm
Format: Article
Language:English
Published: Elsevier
Series:Brazilian Journal of Otorhinolaryngology
Subjects:
Online Access:http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1808-86942017000500546&lng=en&tlng=en
_version_ 1818615168299433984
author Guilherme Henrique Wawginiak
Leonardo Balsalobre
Eduardo Macoto Kosugi
João Paulo Mangussi-Gomes
Raul Ernesto Samaniego
Aldo Cassol Stamm
author_facet Guilherme Henrique Wawginiak
Leonardo Balsalobre
Eduardo Macoto Kosugi
João Paulo Mangussi-Gomes
Raul Ernesto Samaniego
Aldo Cassol Stamm
author_sort Guilherme Henrique Wawginiak
collection DOAJ
description Abstract Introduction: Topical therapies are the best postoperative treatment option for chronic rhinosinusitis, especially those with high volume and pressure, such as the squeeze bottles. However, they are not an available option in Brazil, where irrigation syringes are used. Objective: To investigate the efficacy of topical sinonasal therapy with syringe and the influence of the middle turbinate on this process Methods: Intervention study in training models (S.I.M.O.N.T.). After standard dissection, three interventions were performed (Nasal Spray 4 puffs, 60-mL syringe and 240-mL Squeeze Bottle) with normal and Sutured Middle Turbinate. Images of each sinus were captured after the interventions, totalizing 144 images. The images were classified by 10 evaluators according to the amount of residual volume from zero to 3, with zero and 1 being considered poor penetration and 2 and 3, good penetration. The 1440 evaluations were used in this study. Results: Considering all middle turbinate situations, the amount of good penetrations were 8.1% for Spray; 68.3% for Syringe, and 78.3% for Squeeze (p < 0.0001). Considering all types of interventions, the Normal Middle Turbinate group had 48.2% of good penetrations and the Sutured Middle Turbinate, 55% (p = 0.01). Considering only the Sutured Middle Turbinates, there was no difference between the interventions with Syringe and Squeeze (76.3% vs. 80.4%; p = 0.27). Conclusion: Topical therapy of irrigation with a 60-mL syringe was more effective than that with nasal spray. The status of the middle turbinate proved to be fundamental and influenced topical therapy. Irrigation with syringe was as effective as the squeeze bottle when the middle turbinate was sutured to the nasal septum.
first_indexed 2024-12-16T16:29:37Z
format Article
id doaj.art-9b96e6dd419a49cf85af0ed2e2c65192
institution Directory Open Access Journal
issn 1808-8686
language English
last_indexed 2024-12-16T16:29:37Z
publisher Elsevier
record_format Article
series Brazilian Journal of Otorhinolaryngology
spelling doaj.art-9b96e6dd419a49cf85af0ed2e2c651922022-12-21T22:24:38ZengElsevierBrazilian Journal of Otorhinolaryngology1808-868683554655110.1016/j.bjorl.2016.06.013S1808-86942017000500546Efficacy of syringe-irrigation topical therapy and the influence of the middle turbinate in sinus penetration of solutionsGuilherme Henrique WawginiakLeonardo BalsalobreEduardo Macoto KosugiJoão Paulo Mangussi-GomesRaul Ernesto SamaniegoAldo Cassol StammAbstract Introduction: Topical therapies are the best postoperative treatment option for chronic rhinosinusitis, especially those with high volume and pressure, such as the squeeze bottles. However, they are not an available option in Brazil, where irrigation syringes are used. Objective: To investigate the efficacy of topical sinonasal therapy with syringe and the influence of the middle turbinate on this process Methods: Intervention study in training models (S.I.M.O.N.T.). After standard dissection, three interventions were performed (Nasal Spray 4 puffs, 60-mL syringe and 240-mL Squeeze Bottle) with normal and Sutured Middle Turbinate. Images of each sinus were captured after the interventions, totalizing 144 images. The images were classified by 10 evaluators according to the amount of residual volume from zero to 3, with zero and 1 being considered poor penetration and 2 and 3, good penetration. The 1440 evaluations were used in this study. Results: Considering all middle turbinate situations, the amount of good penetrations were 8.1% for Spray; 68.3% for Syringe, and 78.3% for Squeeze (p < 0.0001). Considering all types of interventions, the Normal Middle Turbinate group had 48.2% of good penetrations and the Sutured Middle Turbinate, 55% (p = 0.01). Considering only the Sutured Middle Turbinates, there was no difference between the interventions with Syringe and Squeeze (76.3% vs. 80.4%; p = 0.27). Conclusion: Topical therapy of irrigation with a 60-mL syringe was more effective than that with nasal spray. The status of the middle turbinate proved to be fundamental and influenced topical therapy. Irrigation with syringe was as effective as the squeeze bottle when the middle turbinate was sutured to the nasal septum.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1808-86942017000500546&lng=en&tlng=enSinusite/terapiaIrrigação terapêuticaCirurgia videoassistidaCirurgia endoscópica por orifício natural
spellingShingle Guilherme Henrique Wawginiak
Leonardo Balsalobre
Eduardo Macoto Kosugi
João Paulo Mangussi-Gomes
Raul Ernesto Samaniego
Aldo Cassol Stamm
Efficacy of syringe-irrigation topical therapy and the influence of the middle turbinate in sinus penetration of solutions
Brazilian Journal of Otorhinolaryngology
Sinusite/terapia
Irrigação terapêutica
Cirurgia videoassistida
Cirurgia endoscópica por orifício natural
title Efficacy of syringe-irrigation topical therapy and the influence of the middle turbinate in sinus penetration of solutions
title_full Efficacy of syringe-irrigation topical therapy and the influence of the middle turbinate in sinus penetration of solutions
title_fullStr Efficacy of syringe-irrigation topical therapy and the influence of the middle turbinate in sinus penetration of solutions
title_full_unstemmed Efficacy of syringe-irrigation topical therapy and the influence of the middle turbinate in sinus penetration of solutions
title_short Efficacy of syringe-irrigation topical therapy and the influence of the middle turbinate in sinus penetration of solutions
title_sort efficacy of syringe irrigation topical therapy and the influence of the middle turbinate in sinus penetration of solutions
topic Sinusite/terapia
Irrigação terapêutica
Cirurgia videoassistida
Cirurgia endoscópica por orifício natural
url http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1808-86942017000500546&lng=en&tlng=en
work_keys_str_mv AT guilhermehenriquewawginiak efficacyofsyringeirrigationtopicaltherapyandtheinfluenceofthemiddleturbinateinsinuspenetrationofsolutions
AT leonardobalsalobre efficacyofsyringeirrigationtopicaltherapyandtheinfluenceofthemiddleturbinateinsinuspenetrationofsolutions
AT eduardomacotokosugi efficacyofsyringeirrigationtopicaltherapyandtheinfluenceofthemiddleturbinateinsinuspenetrationofsolutions
AT joaopaulomangussigomes efficacyofsyringeirrigationtopicaltherapyandtheinfluenceofthemiddleturbinateinsinuspenetrationofsolutions
AT raulernestosamaniego efficacyofsyringeirrigationtopicaltherapyandtheinfluenceofthemiddleturbinateinsinuspenetrationofsolutions
AT aldocassolstamm efficacyofsyringeirrigationtopicaltherapyandtheinfluenceofthemiddleturbinateinsinuspenetrationofsolutions