Nasal Hyperthermia and Simple Irrigation for Perennial Rhinitis

Changes in Inflammatory Mediators

¹ From Department of Pediatrics, The Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, NC.

Study objective: Local nasal hyperthermia or inhalation of heated water vapor is often recommended as a home remedy for various rhinitis disorders such as the common cold and allergic rhinitis. Inhaled heated vapor treatments and simple saline solution nasal irrigation were investigated for their effect on inflammatory mediator production in nasal secretions.

Design: Three treatments were given for nasal irrigation: heated water particles (large particle water vapor) at 43°C, heated molecular water vapor (molecular water vapor) at 41°C, and simple saline solution nasal irrigation. Nasal washes were done before each treatment (baseline), immediately after treatments, and at 30 min, 2, 4, and 6 h. Histamine, prostaglandin D₂, and leukotriene C₄ (LTC₄) concentrations were measured in nasal secretions and compared with baseline values.

Patients and participants: Thirty symptomatic patients with active perennial allergic rhinitis underwent three treatments at weekly intervals.

Measurements and results: Nasal histamine concentrations fell substantially with the nasal irrigation (p<0.0l immediately posttreatment and at 30 min; p<0.05 at 2, 4, and 6 h). Large particle vapor also reduced histamine concentrations for up to 4 h posttreatment compared with baseline values (p<0.05). Alternatively, molecular water vapor did not alter nasal histamine concentrations. Surprisingly, the three treatments did not alter prostaglandin D₂ concentrations over the 6 h. Leukotriene C₄ concentrations fell briefly after the large particle treatment but did not with the molecular water vapor. With saline solution irrigation, LTC₄ concentrations in nasal secretions were lower than baseline at 30 min to 4 h after a treatment (p<0.05).

Conclusions: This study demonstrated the usefulness of large particle vapor treatment and saline solution irrigation in reducing inflammatory mediators in nasal secretions and indirectly supports the clinical efficacy of these treatments for chronic rhinitis.

Key Words: local hyperthermia • nasal saline solution lavages • perennial rhinitis

Submitted on January 13, 2007
Accepted on March 16, 2007

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