Abstract
The upper airway respiratory diseases (i.e. common cold, allergic rhinitis, nonallergic/vasomotor rhinitis, acute and chronic rhinosinusitis and nasal polyposis) in which nasal congestion is a common symptom are often undertreated due to the frequent inadequate efficacy and safety concern with current therapies. In scientific literature, few studies seem to support the hypothesis that nasal inhalatory treatment with thermal water promotes the improvement of nasal symptoms, even if the mechanisms by which the improvement from SPA therapy can be expected remain debated. A prospective comparative study with a pre–post design has been performed consecutively enrolling 33 (males 70 %) patients of both genders older than 12 years of age, affected by chronic sinonasal inflammation. All patients underwent a 14-days course of radioactive water warm vapour inhalations followed by nasal aerosol of the same thermal water 10 min each once/day at Merano Therme. At the beginning and end of the study, in all the subjects, nasal function evaluation by active anterior rhinomanometry, mucociliary transport time (MCTt) determination and nasal cytology were performed. After the inhalatory treatment, the mucociliary function was improved and the pathologic mucociliary transport times recorded at the beginning of the study being significantly reduced to physiologic ones. Besides, before treatment, the cytologic picture showed an inflammatory cell infiltration (eosinophils, neutrophils with/without bacteria, mast cells) in 37 % of patients; after therapy in 66 % of these patients, the rhinocytogram was normal. Our results suggest, according to the literature data, that SPA therapy with radioactive water could represent an alternative choice in chronic inflammatory diseases of the upper airways, nonresponsive to pharmacological therapy.
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References
Shedden A (2005) Impact of nasal congestion on quality of life and work productivity in allergic rhinitis: findings from a large online survey. Treat Respir Med 4:439–446
Kennedy DW (1995) International conference on sinus disease: terminology, staging and therapy. Ann Otol Rhinol Laryngol 104(S167):1–31
Diamond G, Legarda D, Ryan LK (2000) The innate immune response of the respiratory epithelium. Immunol Rev 173:27–38
Fokkens WJ, Scheeren RA (2000) Upper airway defence mechanisms. Paediatr Resp Rev 1:336–341
Vareille M, Kieninger E, Edwards MR, Regamey N (2011) The airway epithelium: soldier in the fight against respiratory viruses. Clin Microbiol Rev 24(1):210–229
Staffieri A, Abramo A (2007) Sulphurous-arsenical-ferruginous (thermal) water inhalations reduce nasal respiratory resistance and improve mucociliary clearance in patients with chronic sinonasal disease: preliminary outcomes. Acta Otolaryngol 127(6):613–617
Passali D, Bellussi L, De Benedetto M, Giordano C, Mira E, Paludetti G, Saglione F (2006) Crenotherapy and upper airways diseases. Acta Otorhinolaryngol Ital 26(4):5–54
Marullo T, Abramo A (2000) Effetti di un ciclo di crenoterapia inalatoria con oligominerali fluoridrati radioattivi. Acta Otorhinolaryngol Ital 20(63):1–13
Grossman J (1997) One airway, one disease. Chest 111:118–168
Corren J, Adinoff A, Irvin C (1992) Changes in bronchial responsiveness following nasal provocation with allergen. J Allergy Clin Immunol 89:611–618
Oliveira CAA, Sole D, Naspitz CK, Rachelefsky GS (1997) Improvement of bronchial hyper-responsiveness in asthmatic children treated for concomitant sinusitis. Ann Allergy Asthma Immunol 79:70–74
Dunlop G, Scadding GK, Lund VJ (1999) Effect of endoscopic sinus surgery on asthma management in patients with chronic rhinosinusitis, nasal polyposis and asthma. Am J Rhinol 13(4):261–265
Clement PAR, Gordon F (2005) Consensus report on acoustic rhinometry and rhinomanometry. Rhinology 43:169–179
Eccles EA (2011) Guide to practical aspects of measurement of human nasal airflow by rhinomanometry. Rhinology 49:2–10
Passàli D, Mezzedimi C, Passàli GC, Nuti D, Bellussi L (2000) The role of rhinomanometry, acoustic rhinometry, and mucociliary transport time in the assessment of nasal patency. Ear Nose Throat J 79(5):397–400
Meltzer EO, Jalowayski AA (1988) Nasal cytology in clinical practice. Am J Rhinology 2:47–54
Bousquet J, Van Cauwenberge P, Khaltaev N, Aria Workshop Group, World Health Organization (2001) Allergic rhinitis and its impact on asthma. J Allergy Clin Immunol 108(5 Suppl):S147–S334
van Cauwenberge P, Bachert C, Passalacqua G, Bousquet J, Canonica GW, Durham SR, Fokkens WJ, Howarth PH, Lund V, Malling HJ, Mygind N, Passali D, Scadding GK, Wang DY (2000) Consensus statement on the treatment of allergic rhinitis. European Academy of Allergology and Clinical Immunology. Allergy 55(2):116–134
Salami A, Dellepiane M, Crippa B, Mora F, Guastini L, Jankowska B, Mora R (2008) Sulphurous water inhalations in the prophylaxis of recurrent upper respiratory tract infections. Int J Pediatr Otorhinolaryngol 72(11):1717–1722
Costantino M, Lampa E, Nappi G (2006) Effectiveness of sulphur spa therapy with politzer in the treatment of rhinogenic deafness. Acta Otorhinolaryngol Ital 26:7–13
Salami A, Dellepiane M, Strinati F, Guastini L, Mora R (2010) Sulphurous thermal water inhalations in the treatment of chronic rhinosinusitis. Rhinology 48(1):71–76
Passali D, Bellussi L, Bianchini Ciampoli M, De Seta E (1984) Experiences in the determination of nasal mucociliary transport time. Acta Otolaryngol 97(3–4):319–323
Puchelle E, Aug F, Pham QT, Bertrand A (1981) Comparison of three methods for measuring nasal mucociliary clearance in man. Acta Otolaryngol 91(3–4):297–303
Boatsman JE, Calhoun KH, Ryan MW (2006) Relationship between rhinosinusitis symptoms and mucociliary clearance time. Otolaryngol Head Neck Surg 134(3):491–493
Arnaoutakis D, Collins WO (2011) Correlation of mucociliary clearance and symptomatology before and after adenoidectomy in children. Int J Pediatr Otorhinolaryngol 75(10):1318–1321
Passàli D, Ferri R, Becchini G, Passàli GC, Bellussi L (1999) Alterations of nasal mucociliary transport in patients with hypertrophy of the inferior turbinates, deviations of the nasal septum and chronic sinusitis. Eur Arch Otorhinolaryngol 256(7):335–337
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Passali, D., De Corso, E., Platzgummer, S. et al. SPA therapy of upper respiratory tract inflammations. Eur Arch Otorhinolaryngol 270, 565–570 (2013). https://doi.org/10.1007/s00405-012-2024-5
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DOI: https://doi.org/10.1007/s00405-012-2024-5