80 children with sinusitis were treated with amoxycillin and a decongestive preparation 1. In 50 of them healing was incomplete and the usefulness of irrigation of the maxillary sinus was studied: one group was treated with antroscopy and sinuscopy while the second group did not receive this treatment (control). In both groups control X-rays were performed after three weeks. There was no significant difference between the two groups.
A placebo-controlled prospective study was performed to evaluate conservative treatment of chronic maxillary sinusitis in children. Antibiotic treatment and drainage did not seem to have a permanent curative effect 2.
In a randomized double blind study, the effect of nasal wash with hypertonic saline (HS) (3.5%) versus normal saline (NS) (0.9%) were compared in thirty patients with chronic sinusitis aged 3 to 16 3. They were randomly divided into two treatment groups matched by age and severity of the disease. All patients were treated for 4 weeks and evaluated by two clinical scores (cough and nasal secretions/postnasal drip [PND]) and by a radiology score at the beginning and end of the study. The HS group improved significantly in all scores (average +/- SD): cough score, from 3.6 +/- 0.51 to 1.6 +/- 0.74; nasal secretion/PND score, from 2.86 +/- 0.35 to 1.6 +/- 0.74; and radiology score, from 8.06 +/- 1.28 to 2.66 +/- 1.04. The NS treatment group showed significant improvement only in the PND score (from 2.66 +/- 0.49 to 1.53 +/- 0.83) but no significant change in both the cough score (from 3.53 +/- 0.52 to 3.33 +/- 0.49) and the radiology score (from 8.13 +/- 1.25 to 7.86 +/- 0.91). Clinical observation 1 month after the end of the study showed no change compared with the end of the study in both groups.
Comment: The quality of evidence is downgraded by study quality (inadequate or unclear allocation concealment) and by imprecise results (few patients and wide confidence intervals).
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