title: Nasal irrigation as an adjunctive treatment in allergic rhinitis: a systematic review and meta-analysis.
abstract: BACKGROUND
  Saline nasal irrigation (SNI) is often recommended as additional nonpharmacologic treatment, having proven its efficacy in acute and chronic rhinosinusitis and for therapy after sinonasal surgery. To date, however, no systematic review or meta-analysis exists  showing the influence of SNI on allergic rhinitis (AR). This study aimed to establish the impact of SNI on symptoms of AR in different patient groups.
  
  
  METHODS
  We conducted a systematic search of Medline, Embase, Cochrane Central Register of Controlled Trials, and ISI Web  of Science databases for literature published from 1994 to 2010 on SNI in AR. Prospective, randomized, controlled trials that assessed the effects of SNI on four different outcome parameters were included. The evaluation focused on primary (symptom score) and secondary parameters (medicine  consumption, mucociliary clearance, and quality of life).
  
  
  RESULTS
  Three independent reviewers chose 10 originals that satisfied the inclusion criteria (>400 participants total) from 50 relevant trials. SNI performed regularly over a limited period of up to 7 weeks was  observed to have a positive effect on all investigated outcome parameters in adults and children with AR. SNI produced a 27.66% improvement in nasal symptoms, a 62.1% reduction in medicine consumption, a 31.19% acceleration of mucociliary clearance time, and a 27.88% improvement in quality  of life.
  
  
  CONCLUSIONS
  SNI using isotonic solution can be recommended as complementary therapy in AR. It is well tolerated, inexpensive, easy to use, and there is no evidence showing that regular, daily SNI adversely affects the patient's health or causes unexpected side  effects.
authors.affiliation: Institute of Medical Statistics, Informatics and Epidemiology, University of Cologne, Cologne, Germany.
authors.forename: Kristina E
authors.initials: KE
authors.lastname: Hermelingmeier
authors.forename: Rainer K
authors.initials: RK
authors.lastname: Weber
authors.forename: Martin
authors.initials: M
authors.lastname: Hellmich
authors.forename: Christine P
authors.initials: CP
authors.lastname: Heubach
authors.forename: Ralph
authors.initials: R
authors.lastname: Mösges
mesh_terms: D000281:Administration, Intranasal; D006801:Humans; D007552:Isotonic Solutions; D012221:Rhinitis, Allergic, Perennial / Q000628:therapy*; D006255:Rhinitis, Allergic, Seasonal / Q000628:therapy*; D012965:Sodium Chloride / Q000627:therapeutic use*; D007507:Therapeutic Irrigation / Q000379:methods*
chemical_list: D007552:Isotonic Solutions; D012965:Sodium Chloride