Abstract
Objectives/Hypothesis:
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.
Study Design:
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.