title: The potential role of hyaluronan in minimizing symptoms and preventing exacerbations of chronic rhinosinusitis.
abstract: BACKGROUND
  This study was designed to prospectively evaluate the role of nebulized hyaluronic acid (HA) given for 10 days/mo over 3 months as adjunct treatment to minimize symptoms and preventing exacerbation of chronic rhinosinusitis (CRS).
  
  
  METHODS
  Thirty-nine eligible patients were randomized to receive nebulized 9-mg sodium hyaluronate nasal washes plus saline solution (21 patients) or 5 mL of saline alone (18 patients), according to an open-label, parallel-group design, with blind observer assessment. A questionnaire about main CRS discomfort and nasal endoscopy for mucous discharge and/or mucosal edema of nasal cavities was used to assess primary outcomes of treatments. Secondary outcome measures included side effects and satisfaction.
  
  
  RESULTS
  HA significantly improved quality of life in CRS patients according to the CRS questionnaire (16± 3.72 versus 11.52 ± 4.28; p < 0.001), contrary to saline group scores (18.92 ± 3.09 versus 18.21 ± 3.21; p = 0.55). The HA group showed significantly reduced osteomeatal edema (2.42 versus 1.52; p < 0.001) and secretions (0.95 versus 0.42; p < 0.001), whereas there was no statistically significant difference in the saline group. The compliance to the treatment was similar in both groups and no side effects were recorded.
  
  
  CONCLUSIONS
  The results of this study suggested that intermittent treatment with topical 9-mg sodium hyaluronate plays a role in minimizing symptoms and could prevent exacerbations of CRS.
authors.affiliation: Department of Otolaryngology, University Campus Bio-Medico, Rome, Italy.
authors.forename: Manuele
authors.initials: M
authors.lastname: Casale
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Sabatino
authors.forename: Valeria
authors.initials: V
authors.lastname: Frari
authors.forename: Francesco
authors.initials: F
authors.lastname: Mazzola
authors.forename: Rosa
authors.initials: R
authors.lastname: Dell'Aquila
authors.forename: Peter
authors.initials: P
authors.lastname: Baptista
authors.forename: Ranko
authors.initials: R
authors.lastname: Mladina
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Salvinelli
mesh_terms: D000328:Adult; D002908:Chronic Disease; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012220:Rhinitis / Q000150:complications / Q000188:drug therapy*; D012852:Sinusitis / Q000150:complications / Q000188:drug therapy*
chemical_list: D006820:Hyaluronic Acid