Comparison of a Hypertonic Tannin-rich Solution vs 3% NaCl Solution as Treatment for Rhinosinusitis

摘要

  ABSTRACT Rhinosinusitis (RS), chiefly viral in origin, is increasingly widespread, and puts heavy financial burdens on society. Treatments range from home remedies and alpha-adrenergic agonistic decongestants to antibiotics, corticosteroids, and even surgery. Much discomfort, pain, individual and societal cost, could be avoided through efficient, judicious and cost-effective treatments. In absence of a specific and effective treatment for RS, saline water nasal irrigation is considered safe and beneficial. In a simple scientific approach to find a novel remedy that would target not only the symptoms but also the causes of RS, a tannin-rich hypertonic solution for nasal spray was formulated and evaluated for efficacy against traditional saline. Tannin-rich plant extracts (procyanidins or PCDs) showing anti-bacterial, influenza virus-neutralizing activity were identified in vitro, and incorporated into a hypertonic glycerol solution. A pilot randomized, single blind trial was conducted on 113 RS patients not undergoing any other treatment: 51 patients received a 3% NaCl solution as placebo saline spray (PSS), while 62 patients received the PCD-containing, hypertonic solution. 3-4 sprays of the products were applied twice daily for 21 days (maximum) or until recovery. Rhinosinusitis symptom severity scores were recorded. Although PSS proved beneficial, the PCD-glycerol solution produced a much greater, statistically significant improvement with regard to speed and degree of symptom reduction, leading to a lesser need for antibiotherapy. Results show that the use of a non-irritant hypertonic solution containing specific tannins represents a new, efficient, safe and cost effective approach to treat RS.