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Laryngorhinootologie 2011; 90(06): 346-351
DOI: 10.1055/s-0031-1275317
Übersicht
Georg Thieme Verlag KG Stuttgart · New York

Nasenspülungen bei akuter Rhinosinusitis

Nasal Douching in Acute Rhinosinusitis
T. Hildenbrand
1   Städtisches Klinikum Karlsruhe, HNO-Klinik, Karlsruhe
,
R. Weber
1   Städtisches Klinikum Karlsruhe, HNO-Klinik, Karlsruhe
,
C. Heubach
2   Universität zu Köln, Institut für Medizinische Statistik, Informatik und Epidemiologie (IMSIE), Köln
,
R. Mösges
2   Universität zu Köln, Institut für Medizinische Statistik, Informatik und Epidemiologie (IMSIE), Köln
› Author Affiliations
Further Information

Publication History

Publication Date:
25 May 2011 (online)

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Zusammenfassung

Hintergrund:

Nasenspülungen werden bei einer Vielzahl von Erkrankungen der Nase und Nasennebenhöhlen empfohlen. Bei der chronischen Rhinosinusitis und nach Nasennebenhöhlenoperation hat sich die Nasendusche mit Salzlösungen als wirksam erwiesen und wird von einigen Fachgesellschaften als supportive Therapie empfohlen.

Material und Methoden:

In einer systematischen Literaturrecherche wurde die Wirksamkeit von Nasenspülungen mit Salzlösungen zur Prophylaxe und Therapie der akuten Rhinosinusitis geprüft. Gleichzeitig wurde untersucht, ob eine langfristige Spülung schädlich sein kann und zu vermehrten Infekten führt.

Ergebnisse:

Nasenspülungen mit Salzlösung zeigen bei der akuten Rhinosinusitis des Erwachsenen eine begrenzte, aber vorhandene Wirksamkeit (Evidenzlevel Ia). Sie sind bei Kindern mit einer akuten Rhinosinusitis in Ergänzung zur üblichen Medikation wirksam (Evidenzlevel Ib) und weisen einen präventiven Effekt bei Infektneigung auf (Evidenzlevel IIb). Als Wirkmechanismus wird eine Verbesserung der Schleimhautfunktion angenommen. Bisher gibt es keinen Hinweis, dass dauerhafte tägliche isotone Nasenspülbehandlungen die Gesundheit von Patienten nachteilig beeinflussen und zu häufigeren Infekten führen.

Schlussfolgerung:

Nasenspülungen mit Salzlösungen können empfohlen werden bei der Therapie der akuten Rhinosinusitis des Erwachsenen (Empfehlungsgrad A), der ergänzenden Therapie der akuten Rhinosinusitis des Kindes (Empfehlungsgrad A) und bei Infektneigung zur Prävention (Empfehlungsgrad B).

Abstract

Nasal Douching in Acute Rhinosinusitis

Background:

Nasal douching is recommended for the treatment of a variety of diseases of the nose and paranasal sinuses. Nasal douching with saline solution has proven to be effective in chronic rhinosinusitis and after sinus surgery and is recommended by different otolaryngologic societies.

Material and Methods:

A systematic review of the literature was performed to determine whether nasal douching is effective in the treatment of acute rhinosinusitis and in preventing recurrent upper respiratory tract infections. We also reviewed whether nasal douching has adverse effects and can lead to recurrent upper respiratory tract infections if performed regularly over a longer period of time.

Results:

Nasal douching with saline solution has a limited effekt in adults with acute rhinosinusitis (level of evidence Ia). It is effective in children with acute rhinosinusitis in addition to the standard medication (level of evidence Ib) and can prevent recurrent infections (level of evidence IIb). It is assumed that nasal douching improves the function of the mucous membranes. There is currently no evidence that daily nasal douching with isotonic saline solution over a longer period of time has an adverse effekt on the individual health or leads to a higher rate of infections.

Conclusion:

Nasal douching with saline solutions can be recommended for adults with acute rhinosinusitis (grade of recommendation A), in addition to the standard medication in children with acute rhinosinusitis (grade of recommendation A) and to prevent recurrent infections (grade of recommendation B).

Schlüsselwörter

akute Rhinosinusitis - Nasendusche - Nasenspülung - Infektneigung - langfristige Spülung - Emser Salz - isotone Kochsalzspülung - hypertone Kochsalzspülung

Keywords

acute rhinosinusitis - nasal douching - nasal lavage - recurrent infections - long-term nasal douching - Emser saline solution
 

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