A randomized, double-blind, within-person trial of hot saline at 42 °C for endoscopic sinus surgery.

BACKGROUND

The efficacy and safety of 42 °C hot saline irrigation in haemostasis remain unclear.

AIMS/

OBJECTIVES

This study aimed to investigate the effects of hot saline irrigation at 42 °C during endoscopic sinus surgery (ESS) to assess its efficacy in reducing intraoperative bleeding.

MATERIAL AND

METHODS

In this randomized, double-blind, within-person trial, 13 patients with bilateral chronic rhinosinusitis with nasal polyps undergoing ESS were randomly assigned to receive 42 °C hot saline irrigation on one side and room-temperature saline irrigation as a control on the contralateral side. The primary outcome was the Boezaart surgical field score, while secondary outcomes included operative time, histopathological changes, and postoperative complications. The Wilcoxon signed-rank test was used for statistical analyses.

RESULTS

The Boezaart surgical field score significantly improved with hot saline irrigation compared with the control during anterior ethmoid surgery (p = 0.046); however, no significant difference was observed during posterior ethmoid and sphenoid surgeries. Operative times were comparable between groups. No adverse tissue changes or postoperative complications were observed.

CONCLUSIONS AND SIGNIFICANCE: Hot saline irrigation at 42 °C improved surgical field visibility during ESS without adverse effects, demonstrating its potential as a haemostatic adjunct. This cost-effective and safe technique warrants further investigation for broader clinical application.

TRIAL REGISTRATION: UMIN Clinical Trials Registry: UMIN000052864.