. Author manuscript; available in PMC: 2023 Apr 9.

Published in final edited form as: Int Forum Allergy Rhinol. 2022 Jan 10;12(9):1148–1183. doi: 10.1002/alr.22953

Table IV:

Summary of evidence on nasal saline

Study	Year	Study Design	LOE	Number of Subjects	Study Groups	Intervention	Primary Endpoint	Conclusion
Mainz²⁹	2016	RCT	2	69 patients	CF CRS	Inhaled NaCl 0.9% versus Inhaled NaCl 6.0%	SNOT-20 Rhinomanometry Inflammatory markers in nasal lavage	Both treatment groups exhibited a significant improvement in SNOT-20, but one treatment was not significantly better than the other. There was a nonsignificant improvement in rhinometry.
Aanaes³²	2018	Case series	4	12 patients	CF CRS	Nasal saline with radiotracer delivered after ESS	Dynamic SPECT scan to measure sinonasal delivery of nasal saline following ESS	10/24 maxillary sinuses exhibited improvement compared with preoperative levels. No saline reached the frontal or sphenoid sinuses. Fluid reached the ethmoid sinuses and the maxillary sinuses were 23% filled, on average.
Jayawardena³⁰	2020	Survey of providers	5	175 respondents who care for patients with CF CRS	Otolaryngologists and pulmonologists	Survey regarding the management of CF CRS	Achieving consensus of ≥75% agreement amongst respondents	93% of respondents felt that maximal medical management of CF CRS should include nasal saline irrigations
Farzal³¹	2021	Survey of providers/patients	5	427 respondents including providers, patients, and caregivers	Otolaryngologists, pulmonologists, CF patients, CF caregivers	Survey regarding the management of CF CRS	Nasal saline irrigation usage	67% of prescribers advocate isotonic nasal saline irrigations, while 29% recommend hypertonic saline irrigations.

CF: cystic fibrosis; CRS: chronic rhinosinusitis; RCT: randomized control trial; SNOT-20: 20 item Sino-Nasal Outcome Test