Zamzam Water versus Saline Irrigations as Adjuvant Treatment of Chronic Rhinosinusitis, Among Patients Attending Otolaryngology Clinic; A Double Blind Randomized Controlled Trial at King Fahad General Hospital, Jeddah

Dr. Ghofran Siraj Khogeer

Joint Program Family & Community Medicine, Jeddah – 2014

Background: Chronic rhinosinusitis (CRS) is one of the most common problems in primary care settings and ENT practice.  Saline nasal irrigation is commonly used as an adjunctive therapy of CRS as recommended by current guidelines.

Objectives:  to compare the effectiveness of Zamzam nasal irrigation versus normal saline (NS) irrigation in the symptomatic treatment of CRS.

Methods: A double-blind randomized controlled trial with a total of 40 symptomatic adult patients was conducted at otolaryngology clinics of KFGH.  Patients completed a  Modified Arabic Sino-Nasal Outcomes Test 20 (MA-SNOT) checklist (primary outcome) and underwent nasal endoscopic examination (secondary outcome).  The experimental group (n = 20) used Zamzam nasal irrigation and the control group (n = 20) used normal saline irrigation.  The patients were followed up every week for three weeks.

ResultsThe experimental and control groups were similar in pretreatment characteristics except for gender as males were 6 (30%) and 13 (65%) respectively.  Thirty-three patients completed the study. Regarding the primary outcome, Zamzam and NS groups showed a significant improvement in MA-SNOT mean scores at baseline, 1 week, 2 weeks and 2nd visit (p-value between 1st  and 2nd visit was < 0.01).   However, there was no significant difference in the degree of improvement between both groups (p = 0.251). The secondary outcome was based on symptomatic improvement and endoscopic examination at the 2nd visit for Zamzam and NS groups.  The symptomatic improvement for each item in the MA-SNOT score was measured for both groups based on intention to treat analysis.   Furthermore, there was no significant difference in secondary outcomes between the two groups.

Conclusion:  Treatment with Zamzam irrigation appears as effective as normal saline irrigation and can be used for symptomatic reduction in patients suffering from CRS

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