Medical Hydrology and Balneology: Environmental Aspects

Smoking and chronic rhinitis: effects of nasal
irrigations with sulfurous-arsenical- ferruginous
thermal water. A prospective, randomized,
double-blind study
Staffieri A (1) , Marioni G (1) , Staffieri C (1) , Lionello M (1) , Ottaviano G (1)
(1) Department Neurosciences. Section of Otolaryngology. University of Padova. Italy
alberto.staffieri@unipd.it
Introduction and Objectives
Smoking is a self-destructive behavior1 that is known to induce remodeling of
the lower airways, leading to squamous metaplasia, but little is known about its
effects on the nose and paranasal sinuses2. Smoking is a strong independent risk
factor of olfactory impairment3 probably as consequence of anatomical changes
that occur in the olfactory mucosa, such as squamous metaplasia4 and a reduction
in the number and size of the olfactory vessels and cilia5. Nasal irrigations are
often mentioned as measures for treating sinonasal inflammations. Unfortunately,
studies conducted on the benefits of nasal irrigations have often been small and
poorly controlled, and their conclusions have not always been evidence-based6. The
purpose of our study was to compare the effects of nasal irrigations with sulfurousarsenical-ferruginous
thermal water or isotonic sodium chloride solution in smokers
with non-allergic chronic rhinosinusitis, based on clinical and olfactory evidences.
Materials and Methods
The present was a prospective, randomized, double-blind study performed in a
tertiary academic referral center. Seventy smokers with non-allergic chronic rhinitis
were enrolled. Nasal endoscopy, rhinomanometry, nasal cytology and odor threshold
measurements were performed in subjects randomized to daily nasal irrigations
with either thermal water or isotonic sodium chloride solution for 1 month.
Results
Immediately after the treatment, the thermal water irrigations revealed a positive
pharmacological action, judging from a tendency towards lower nasal resistances
(p=0.07), and larger numbers of ciliated cells in the patients treated (p=0.003).
Endoscopic findings in the thermal water group were still better than in the control
group a further two months later (p=0.03).
Conclusions
Our results indicate that nasal irrigations with thermal water had a good effect on
endoscopic objective signs, nasal resistances and epithelial trophism.
Balnea
2012, núm. 6, 72-73
72
ISBN: 978-84-669-1887-0
978-84-669-3482-4