Table 2.

Systematic presentation of the studies included.

Author	Year	Jadad score	Number of patients thermal water/control	Age span/average age	Duration of treatment	Measurement time points	Inclusion criteria	Exclusion criteria
De Luca et al. [53]	2006	3	40/—	74–100/86,5	12 days	Baseline Follow-Up: Day 12	(i) Presence of chronic rhinitis or chronic rhinosinusitis (ii) Allergic or vasomotor nasal hyperactivity (iii) Chronic laryngitis (iv) Chronic pharyngitis	(i) Acute pathologies in ENT region (ii) Steroids, mucolytics, antihistamine, NSAIDs, vasoconstrictive drugs or antibiotics in the last 30 days (iii) Autoimmune disease (iv) Patients with malignant neoplasms, surgical intervention, and/or radio chemotherapy
Marullo and Abramo [29]	2000	3	27/20	15–81/52.4	12 days	Baseline Follow-Up: Day 12	(i) At least 3 confirmed episodes of sinonasal infection in the previous 12 months (ii) Evidence of chronic sinonasal inflammation at objective otorhinolaryngologic evaluation	(i) Vasoconstrictive drugs, local and systemic steroids, NSAIDs, antihistamine, and mucolytics in the last 2 months (ii) Patients who for various reasons were not able to ensure the conclusion of the study (iii) Patients who present anterior rhinoscopy
Miraglia del Giudice et al. [60]	2011	5	20/20	6–14/	15 days a month for 3 months	Baseline Follow-Up: Week 12, 14	(i) Age from 6 to 14 (ii) History of seasonal moderate to severe allergic rhinitis for at least 2 years (iii) Positive skin prick test to Parietaria pollen (iv) History of mild intermittent asthma	(i) Antihistamines, intranasal, bronchial, or systemic corticosteroids, cromolyn sodium, and leukotriene modifiers in the previous 6 weeks (ii) sinus and/or upper or lower respiratory tract infection, persistent asthma, nasal surgery within the last year, respiratory tract abnormalities, and systemic diseases
Ottaviano et al. [27]	2012	5	35/35	18–65/ not specified	12 weeks	Baseline Follow-Up: Day 30, 90	(i) Age from 18 to 65 (ii) Nonallergic chronic rhinitis (iii) Cigarette smoking habit for at least 5 years	Autoimmune diseases, cystic fibrosis, and diabetes
Ottaviano et al. [28]	2011	8	40/40	18–65/ not specified	1 month	Baseline Follow-Up: Day 30	(i) Age from 18 to 65 (ii) Nonallergic chronic rhinosinusitis	Autoimmune diseases, cystic fibrosis, and diabetes
Passali et al. [58]	2013	3	33/—	12 years and older/  not specified	14 days	Baseline Follow-Up: Day 14	(i) Nasal obstruction evaluated by a 10-point Visual Analog Scale (1: nasal airways completely free; 10: nasal airway completely blocked) higher than 7 in the previous 2 months (ii) Chronic rhinosinusitis, persistent allergic rhinitis, vasomotor rhinitis with inferior turbinate hypertrophy	(i) Acute viral rhinitis (ii) Obstructive polyposis (iii) Nasal steroid, vasoconstrictive drug therapies or systemic NSAIDs, oral steroids and mucolytic treatment in the previous 2 months
Passali et al. [59]	2008	3	60/60	15–65/not specified	14 days	Baseline Follow-Up: Day 14	Chronic rhinosinusitis with/or nasal polyposis of I second degree of the Lund-Mackay-Classification [62]	Not specified
Passariello et al. [57]	2012	3	60/—	2–12/3.4 ± 1	15 days	Baseline Follow-Up: Day 15	(i) Age from 2 to12 (ii) CRS (iii) One or more of the following sinonasal symptoms: nasal discharge, congestion, obstruction, postnasal drip, daytime cough, and foul breath (iv) Failed courses of antibiotics, saline irrigation, nasal steroids, or antihistamine (v) Persistent symptoms for ≥1 month	(i) Steroids, nonsteroidal anti-inflammatory drugs, antihistamines, and vasoconstrictors in the previous 4 weeks (ii) Primary diagnosis of obstructive sleep apnea syndrome caused by tonsillar hyperplasia (iii) Chronic diseases, immunodeficiency, and neurological impairment (iv) Varicose veins of the nasal septum, and suspect ciliary abnormalities (v) Previous sinonasal surgery (vi) Malformation of the upper airway sinonasal osteogenesis, tumors, and obstructive lesions (vii) History of facial trauma that distorted the sinus anatomy
Salami et al. [26]	2010	5	40/40	26–58/46.4	12 days	Baseline Follow-Up: Day 12, 90	CRS without polyps	(i) Immunostimulant or immunosuppressive agents in the previous 6 months (ii) Genetic and congenital condition: cystic fibrosis and primary ciliary dyskinesia (iii) Nasal polys (iv) Positive allergy testing (v) Anatomic abnormalities (severe septal deviation among others) (vi) Acquired mucociliary dysfunction (vii) Neoplasms (viii) Acute contemporary bacterial and/or viral rhinosinusitis, middle ear, and respiratory tract (ix) Bronchopulmonary disease (x) Nasal trauma (xi) Smoker (xii) Previous nasal and sinus surgery
Salami et al. [25]	2008	7	50/50	6–14/9	12 days	Baseline Follow-Up: Day 12, 90	At least 3 acute episodes of upper respiratory tract infections in the last year	(i) Immunostimulant or immunosuppressive agents in the previous 6 months (ii) Previous adenoidectomy and/or tonsillectomy (iii) Anatomic anomalies (iv) Other acute infections (v) Allergic rhinitis (vi) Congenital immunodeficiency's   (vii) Pulmonary disease
Staffieri et al. [56]	2008	5	40/40	18–65/not specified	6 months	Baseline Follow-Up: Day 30, 90, 180	(i) Age from 18 to 65 (ii) CRS not responding to medical treatment (iii) No contraindications to general anaesthesia and FESS	(i) Autoimmune disease (ii) Cystic fibrosis (iii) Diabetes (iv) Sinonasal inverted papilloma or sinonasal malignancy
Staffieri and Abramo [55]	2007	4	37/—	40/not specified	12 days	Baseline Follow-Up: Day 12	(i) At least 3 confirmed episodes of sinonasal infection in the previous 12 months (ii) Evidence of chronic sinonasal inflammation at otorhinolaryngologic endoscopic evaluation	Nasal steroid, vasoconstrictive drug therapies or systemic NSAIDs, and steroid or mucolytic treatments in the previous 2 months
Staffieri et al. [54]	1998	3	25/25	18–83/50.5	12 days	Baseline Follow-Up: Day 12	Chronic rhinopharyngotubaric inflammation	Not specified