title: Xylitol nasal irrigation in the management of chronic rhinosinusitis: a pilot study.
abstract: OBJECTIVE
  To determine the tolerability of xylitol mixed with water as a nasal irrigant and to evaluate whether xylitol nasal irrigation results in symptomatic improvement of subjects with chronic rhinosinusitis.
  
  
  METHODS
  A prospective, randomized, double-blinded, controlled crossover pilot study.
  
  
  METHODS
  Twenty subjects were instructed to perform sequential 10-day courses of daily xylitol and saline irrigations in a randomized fashion, with a 3-day washout irrigation rest period at the start of each treatment arm. Collected data included patient characteristics, along with Sino-Nasal Outcome Test 20 (SNOT-20) and Visual Analog Scale (VAS) scores reported at the beginning and end of each irrigation course.
  
  
  RESULTS
  Fifteen of the 20 subjects (75%) returned their SNOT-20 and VAS data for analysis. There was a significant reduction in SNOT-20 score during the xylitol phase of irrigation (mean drop of 2.43 points) as compared to the saline phase (mean increase of 3.93 points), indicating improved sinonasal symptoms (P = .0437). There was no difference in VAS scores. No patient stopped performing the irrigations owing to intolerance of the xylitol, although its sweet taste was not preferred by three subjects (21%). One patient reported transient stinging with xylitol.
  
  
  CONCLUSIONS
  Xylitol in water is a well-tolerated agent for sinonasal irrigation. In the short term, xylitol irrigations result in greater improvement of symptoms of chronic rhinosinusitis as compared to saline irrigation.
authors: Department of Otolaryngology-Head and Neck Surgery, Stanford Hospital and Clinics, Stanford, California, USA.
authors: Joshua D
authors: JD
authors: Weissman
authors: Francisca
authors: F
authors: Fernandez
authors: Peter H
authors: PH
authors: Hwang
mesh_terms: D000328:Adult; D002908:Chronic Disease; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055556:Nasal Lavage / Q000379:methods*; D010147:Pain Measurement; D010865:Pilot Projects; D011446:Prospective Studies; D012220:Rhinitis / Q000628:therapy*; D012852:Sinusitis / Q000628:therapy*; D012965:Sodium Chloride / Q000008:administration & dosage; D011795:Surveys and Questionnaires; D014993:Xylitol / Q000008:administration & dosage*
chemical_list: D012965:Sodium Chloride; D014993:Xylitol