الفهرس 
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Abstract
Upper respiratory tract infections, rhinosinusitis, and allergic
rhinitis are among the most frequent reasons for visits to primary care
physicians and are the leading causes of absenteeism in the United States
(Tomooka et al, 2000).
Nasal irrigation is a simple and inexpensive treatment which
relieves the symptoms of a variety of sinus and nasal conditions
(including infectious and allergic entities). Isotonic saline was first
introduced for nasal irrigation, while hypertonic saline has recently been
popularised as it has been found to decrease oedema and improve
mucociliary clearance (Ural et al, 2009). Many scientific studies have
been published proving its beneficial effects on clearing secretions, as
well as its positive effects on the elimination of symptoms and improving
the quality of life for its users (Friedman et al, 2006).
There has been increasing use of saline irrigation, douches, sprays
and rinsing as an adjunct to the medical management of chronic
rhinosinusitis. Treatment strategies often include the use of topical saline
from once to more than four times a day (Harvey et al, 2007).
Hypertonic saline nasal irrigation (HSNI) is an adjunctive therapy
for rhinosinusitis and sinus symptoms. It flushes the nasal cavity,
facilitating the evacuation of potentially allergen- and irritant-containing
mucus (Rabago et al, 2008). The Potential efficacy is supported by the
Observation that hypertonic saline improves mucociliary clearance, thins
mucus, and may decrease inflammation (Rabago et al, 2002).
summary
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The mechanical clearance of mucus is commonly proposed as the
sole basis of its benefit. However, there is an increasing perception that
saline has a contributory role in the resolution of inflammation and does
not just relieve symptoms for mechanical reasons (Harvey et al, 2007).
Harvey et al., 2007, Lance et al., 2009, URAL et al., 2009,
Hauptman and Ryan in 2007, Adam et al., 1998 and Farag et al.,
2013, found that there are no significant differences in overall subjective
symptoms related to sinonasal disease between isotonic Saline and
hypertonic saline irrigation.
While Shoseyov et al., 1998, Rabago et al., 2002, Rabago et
al., 2006, David et al., 2008, Friedman et al., 2012, Alice and Satish,
2013 and Martin et al., 2007, found that there is Some evidence
suggests that hypertonic solutions improve objective measures and
hypertonic saline is recommended over isotonic solution.
As conculsion nasal irrigation using hypertonic solution was tested
against other saline soulation to treat symptoms of rhinosinusitis that
hypertonic solution is superior to saline in reduction of symptoms and
improvement of the quality of life