Experience of Large-Volume Nasal Irrigation in the Postoperative Period in Severe Nasal Polyposis

To compare the effectiveness and safety of nasal irrigation with a powder solution based on natural salt, baking soda, rosehip, and beetroot extract using various techniques (large-volume irrigation with a squeezable bottle and irrigation via spraying or dripping).A prospective open-label study included 45 patients aged 28 to 49 years, diagnosed with severe, grade 3 chronic rhinosinusitis with nasal polyps. All patients underwent endoscopic nasal polypectomy and endonasal endoscopic opening and revision of all paranasal sinuses. Postoperatively, all patients were advised to irrigate their nasal cavities with a large-volume solution for 14 days. Nasal breathing was assessed using the Visual Analog Scale (VAS), while the physical, functional, and emotional impact of rhinosinusitis was evaluated using the SNOT-22 questionnaire. After the initial irrigation, patients were divided into two groups based on their subsequent care technique: Group 1 (n=33) continued large-volume irrigation using a squeezable bottle. Group 2 (n=12), due to pain experienced during the initial irrigation, used spraying or dripping methods (with a syringe or dropper). Preoperative VAS scores averaged 9.27±2.68, and SNOT-22 scores were 49±1.28. On day 14, Group 1 showed a VAS score of 2.11±0.34 and SNOT-22 score of 10±0.56. Group 2 showed VAS and SNOT-22 scores of 3.85±0.95 and 21±0.94, respectively. Large-volume nasal irrigation using a 240 ml squeezable bottle with the body bent at a 90° angle was found to be significantly more effective than drip or spray methods in improving nasal breathing, overall patient condition, and reducing the risk of postoperative purulent complications.