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Efficacy of sodium hyaluronate in relieving nasal symptoms of children with intermittent allergic rhinitis: a randomized controlled trial

  • Rhinology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

Nasal irrigation is recommended as add-on therapy in patients with intermittent allergic rhinitis (AR). We aimed to evaluate the clinical efficacy of adding hyaluronic acid (HA) or normal saline solution (NSS) to nasal corticosteroid (NC) therapy as add-on therapy in improving quality of life and reducing nasal symptom scores of children with intermittent AR compared to NC therapy.

Method

In this 28-day long, open-label, randomized controlled trial, one puff of NC was administered once a day through both nostrils of 76 children with SAR (6–12 years old), whose Total Nasal Symptom Score (TNSS) was ≥ 4. Twenty-six patients received NC only (Group 1); 24 patients received NSS (Group 2), and 26 patients received HA (Group 3) twice a day by means of nasal douche device. Pediatric Rhinoconjunctivitis Quality of Life Questionnaire (PRQLQ) and TNSS were measured as subjective parameters, and nasal eosinophil count (NEC) in nasal cytology, nasal airflow (NAF), and resistance were measured as objective parameters.

Results

No significant difference was found in post-treatment between groups in terms of TNSS, PRQLQ, and NEC values. Mean values of post-treatment left NAF of the groups were significantly different (p = 0.030), and the mean value of Group 3 was the highest (mean ± SD = 247.62 ± 155.8 ccm/sn). In comparing pre- and post-treatment intragroup mean total NAR (TNAR) values, a statistically significant decrease was recorded only in group three (p = 0.025).

Conclusion

The addition of HA to NC as an adjunct therapy in children with intermittent AR has limited beneficial effects in our study and deserves further investigation.

Trial Registry

The clinical trial registration number ID:NCT04752956.

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Acknowledgements

We appreciate Professor Hasan Yuksel MD for his work on the Turkish translation and validation of the Pediatric Rhinoconjunctivitis Quality of Life Questionnaire (PRQLQ).

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Authors and Affiliations

  1. Department of Child Health and Diseases, Division of Pediatric Immunology and Allergy, University of Health Sciences Turkey, Gülhane Education and Research Hospital, 06010, Ankara, Turkey

    Nazli Ercan

  2. Department of Immunology and Allergy, University of Health Sciences Turkey, Gülhane Education and Research Hospital, 06010, Ankara, Turkey

    Fevzi Demirel, Sait Yeşillik & Özgür Kartal

  3. Department of Child Health and Diseases, University of Health Sciences Turkey, Gülhane Education and Research Hospital, 06010, Ankara, Turkey

    Ahmet Bolat

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Contributions

NE: Conceptualization (lead); writing – original draft (lead); formal analysis (lead); Methodology (lead); writing – review and editing (equal), Investigation; data/evidence collection. FD: Methodology (supporting); writing – review and editing (equal), Supervision, Investigation; data/evidence collection. SY: Methodology (supporting); writing – review and editing (equal), Supervision, Investigation; data/evidence collection. AB: Methodology (supporting); writing – review and editing (equal), Supervision, Investigation; data/evidence collection. OKl: Methodology (supporting); writing – review and editing (equal), Supervision, Investigation; data/evidence collection Additionally, the authors (NE, FD, SY, AB, and OK) have (collectively) personally written at least 90% of the manuscript.

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Correspondence to Nazli Ercan.

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Conflict of interest

The presented work was conducted at University of Health Sciences, Gülhane Education and Research Hospital, Department of Child Health and Diseases, Pediatric Immunology and Allergy Clinic, Ankara/Turkey. Dr. Nazli, Dr. Fevzi, Dr. Sait, Asst. Prof. Ahmet and Assoc. Prof. Ozgur confirmed that they have no conflicts of interest or financial ties to disclose. Authorship statement confirming that all listed authors meet the authorship criteria and that all authors are in agreement with the content of the manuscript.

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Ercan, N., Demirel, F., Yeşillik, S. et al. Efficacy of sodium hyaluronate in relieving nasal symptoms of children with intermittent allergic rhinitis: a randomized controlled trial. Eur Arch Otorhinolaryngol 279, 2925–2934 (2022). https://doi.org/10.1007/s00405-021-07073-0

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