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Medical Forum / Diseases and Disorders / Sinusitis / October 2007Double-blind study on the efficacy of dead sea salt nasal irrigations
2006 Jun A randomized, prospective, double-blind study on the efficacy of dead sea salt nasal irrigations. Friedman M, Vidyasagar R, Joseph N. Department of Otolaryngology and Bronchoesophagology, Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois 60602, USA. hednnek@aol.com OBJECTIVE: The objective of this randomized, prospective, double-blind study was to compare nasal irrigation using hypertonic Dead Sea salt (DSS) solution with hypertonic saline in the treatment of chronic rhinosinusitis and improvement of quality of life (QOL). METHODS: With Institutional Review Board approval, 42 adults seeking treatment for chronic rhinosinusitis in a tertiary university-affiliated medical center were studied. After history and endonasal examination, computed tomography imaging, and QOL survey (Standardized Rhinoconjunctivitis Quality of Life Questionnaire [RQLQ(S)]), patients were randomized to self-administered hypertonic saline spray and irrigation twice daily or hypertonic DSS spray and irrigation. Patients were reassessed weekly and at 1 month. RESULTS: Both groups had similar symptoms and RQLQ(S) scores before treatment and had significant improvement after treatment. However, the DSS patients had significantly better symptom relief and only the DSS group showed improved RQLQ(S) scores. CONCLUSIONS: We present a short-term study providing level I evidence on the superiority of DSS over saline nasal irrigation for treatment of chronic rhinosinusitis. PMID: 16735920 [PubMed - indexed for MEDLINE] ******* I had similar results myself. Jamffer I have a large supply of DSS right at this moment, so I'll try it. No baking soda? Susan > 2006 Jun > A randomized, prospective, double-blind study on the efficacy of dead [quoted text clipped - 27 lines] > I had similar results myself. > Jamffer > x-no-archive: yes > > I have a large supply of DSS right at this moment, so I'll try it. > No baking soda? > > Susan Baking soda kills many bacteria, so it wouldn't hurt. I do halfway between isotonic and hypotonic because hypotonic stings a little. I use a mist sprayer or a bulb syringe. Usually in the morning to get stuff cleared out or before steroid spray, if I need it. Jamffer > Baking soda kills many bacteria, so it wouldn't hurt. > I do halfway between isotonic and hypotonic because hypotonic stings a > little. > I use a mist sprayer or a bulb syringe. > Usually in the morning to get stuff cleared out or before steroid spray, if > I need it. I wouldn't use a bulb syringe on a dare, for reasons Judy mentioned, but I'll try switching to DSS in my NeilMed bottle. It's completely cleanable, and airs out well. Bulb syringes really harbor a lot of moisture in a closed in, dark space, no? Do you keep it filled with bleach solution or vinegar between uses? Susan > x-no-archive: yes > [quoted text clipped - 12 lines] > > Susan To sterilize silicone bulb: bleach, then rinse boiling water, then saturated baking soda solution, thorough rinse with tap water. I guess vinegar would be good also. Jamffer > To sterilize silicone bulb: bleach, then rinse boiling water, then saturated > baking soda solution, thorough rinse with tap water. > I guess vinegar would be good also. > Jamffer But unless you do this immediately before using it, it's going to be colonized by stuff. I had one years ago, and it got all mildewy inside despite intensive cleaning. Not enough air circulation. It's kind of like a silicone sinus. :-) Susan > x-no-archive: yes > [quoted text clipped - 9 lines] > > Susan My thoughts also, I do the boiling water when I boil my irrigation solution. Maybe two or three tablespoons of boiling water, a quick shake and squeeze out. I don't know what would happen if I left the boiling water in too long. I'm not sure if the bleach is a good idea over time. It might break down the silicone, not sure. I think that I'll try vinegar instead of bleach. Jamffer > 2006 Jun > A randomized, prospective, double-blind study on the efficacy of dead [quoted text clipped - 27 lines] > I had similar results myself. > Jamffer I tried it but noticed nothing different. Still have a large bag of dss. What's the mixture ratio for this? Currently I use 8 tsp of non-iodine salt and 4 tsp of baking soda per gallon of water. Would this just be a swap of the salt? Mike ***** > 2006 Jun > A randomized, prospective, double-blind study on the efficacy of dead [quoted text clipped - 34 lines] > I had similar results myself. > Jamffer x-no-archive; yes > What's the mixture ratio for this? Currently I use 8 tsp of non-iodine > salt and 4 tsp of baking soda per gallon of water. Would this just be a > swap of the salt? Usually, it's just a small pinch of baking soda per tsp. I add some xylitol for moisture and for it's anti adherence properties against bacteria. Susan On 10/29/07 7:27 AM, in article 5om8v2FnmhorU4@mid.individual.net, "Susan" <nevermind@nomail.com> wrote: > Usually, it's just a small pinch of baking soda per tsp. I add some > xylitol for moisture and for it's anti adherence properties against > bacteria. > > Susan Good idea Susan, but try to make the Xylitol a 5% solution. > x-no-archive; yes > [quoted text clipped - 3 lines] > > Susan Thanks, but I was wondering if I could substitute the Dead Sea Salt for the non-iodine salt im currently using. The 'recipe' that im using is from my ENT (also out of Rush Chicago). Where can you buy Xylitol and how much would you have to add to a gallon to make a 5% solution? Mike > Thanks, but I was wondering if I could substitute the Dead Sea Salt > for the non-iodine salt im currently using. The 'recipe' that im > using is from my ENT (also out of Rush Chicago). > > Where can you buy Xylitol and how much would you have to add to a > gallon to make a 5% solution? I used it as a substitute last night, but I can't tell you how accurate a swap it was,since the particles are much bigger than the kosher salt I usually use. I hope you're using not only non iodized, but salt with no anti caking agents added? I buy xylitol in the baking section of natural foods groceries. I'm not at all precise about making a 5% solution; I've made it strong and I've made it weak. I don't think anyone has ever published clear superiority of one saline formula/mix over another, but I could be wrong. Susan > What's the mixture ratio for this? Currently I use 8 tsp of non-iodine salt > and 4 tsp of baking soda per gallon of water. Would this just be a swap of > the salt? > > Mike Yes. 8 tsp. per gallon = isotonic or 16 per gallon = hypotonic. At least isotonic and not more than hypotonic is best. If you go below or above those limits you will get swelling of drying. Salt solution draws moisture from the nasal cavity when above isotonic. When below isotonic the reverse happens and you get hydration or swelling. I use half way between so it won't burn too much. In the winter I use isotonic to stop dry nose. I haven't needed any for 5 months now. 4 tsp of baking soda per gallon is what I do. Baking soda helps kill bacteria and is a slight buffer. Happy breathing: Jamffer > Yes. 8 tsp. per gallon = isotonic or 16 per gallon = hypotonic. > [quoted text clipped - 17 lines] > Happy breathing: > Jamffer Thanks, Now does anyone know where I might be able to find Dead Sea Salt in the Chicago area? My ENT also recommended I use a Boric Acid solution and I do it for a few days when im feeling some pressure or changes up there. It produces a different sensation while irrigating than the saline and does seem to make a difference. Although, the saline definitely flushes out more gunk and seems to stay up there longer. Its a pretty good change of pace though. Thanks again, Mike > Now does anyone know where I might be able to find Dead Sea Salt in > the Chicago area? [quoted text clipped - 5 lines] > flushes out more gunk and seems to stay up there longer. Its a pretty > good change of pace though. I buy DSS online, but you might find it in natural body/cosmetic shops or spa shops. Susan On Oct 30, 7:15 am, mjz...@gmail.com wrote: > Now does anyone know where I might be able to find Dead Sea Salt in > the Chicago area? Pretty standard Health Food/Natural Food store stuff, no? That's where I get it. > My ENT also recommended I use a Boric Acid solution and I do it for a > few days when im feeling some pressure or changes up there. It [quoted text clipped - 5 lines] > Thanks again, > Mike I tried Boric Acid once, and it seemed to be too irritating. What recipe did you use. Did you ever try combining saline and Boric Acid? I'm afraid to make things worse, so I'd prefer not being a guinea pig when my nose is clear. Jamffer > I tried Boric Acid once, and it seemed to be too irritating. > [quoted text clipped - 6 lines] > > Jamffer I use 9 tsp of granular boric acid to 1 gallon of boiled water. Its a litter harsher than the saline, but not at all intolerable. No, never tried mixing the two. Not sure if it would do anything as the boric acid is more acidic and the saline is more base. Might cancel each other out and make it PH neutral. My saline solution is more hypertonic as its 8 heaping tsp of salt and 4 tsp baking soda. If I run out of mix, ill use 4 NeilMed packets per 2 cups water. Not as strong, but good in a pinch. I got an ENT appt. on Tuesday, Ill ask about the DSS solution. Mike > I tried Boric Acid once, and it seemed to be too irritating. > [quoted text clipped - 4 lines] > I'm afraid to make things worse, so I'd prefer not being a guinea pig when > my nose is clear. Boric acid is a dessicant, I'd never use it in my nasal passages. Susan > x-no-archive: yes > > Boric acid is a dessicant, I'd never use it in my nasal passages. > > Susan While I do find that it does dry things up a bit, its not anything that I would consider too dry. I try to use the boric acid only when things are acting up. Its possible the acidic nature of this mixture interferes with whatever is up there causing problems. If it keeps me from having to use antibiotics and getting another resistant staph infection, Ill deal with the dryness. Susan, do have web site where you order your DSS from? I went to a health food store and only found the unprocessed salt. Since I've never bought this type of salt, I would like to know that what I'm buying is the good stuff. Thanks, Mike > While I do find that it does dry things up a bit, its not anything that > I would consider too dry. I try to use the boric acid only when things > are acting up. Its possible the acidic nature of this mixture > interferes with whatever is up there causing problems. If it keeps me > from having to use antibiotics and getting another resistant staph > infection, Ill deal with the dryness. I find drying agents cause bleeding and irritation, so I avoid them for that reason. Have you seen any research on the use of BA for this purpose, or comparisons of its effects with saline? > Susan, do have web site where you order your DSS from? I went to a > health food store and only found the unprocessed salt. Since I've never > bought this type of salt, I would like to know that what I'm buying is > the good stuff. Mike, I buy over 100 lbs at a time for use in baths, so YMMV, but I google up prices by the lb. saltworks.com is one of the suppliers with a great product, Bokek. The other one escapes me right now, but the product appears much whiter, so I think it may be stripped of some of its mineral properties. Susan > > What's the mixture ratio for this? Currently I use 8 tsp of non-iodine > salt [quoted text clipped - 3 lines] > > > > Mike Yes, if you want hypertonic. *CORRECTION* 4 tsp. per gallon = isotonic or 8 tsp. per gallon = hypertonic. Hypertonic solutions (salt concentration greater than that of our body) decrease or stop the motility of the cilia. At least isotonic, or well below hypertonic is best. If you go below or above those limits you will get swelling of drying. Salt solution draws moisture from the nasal cavity when above isotonic. When below isotonic the reverse happens and you get hydration or swelling. I use less than half way between so it won't burn too much. In the winter I use isotonic to stop dry nose. I haven't needed any for 5 months now. 4 tsp of baking soda per gallon is what I do. Baking soda helps kill bacteria and is a slight buffer. Happy breathing: Jamffer |
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