• Joshua D Weissman, Francisca Fernandez, and Peter H Hwang.
• Department of Otolaryngology-Head and Neck Surgery, Stanford Hospital and Clinics, Stanford, California, USA.
• Laryngoscope. 2011 Nov 1; 121 (11): 2468-72.

Objectives/HypothesisTo determine the tolerability of xylitol mixed with water as a nasal irrigant and to evaluate whether xylitol nasal irrigation results in symptomatic improvement of subjects with chronic rhinosinusitis.Study DesignA prospective, randomized, double-blinded, controlled crossover pilot study.MethodsTwenty subjects were instructed to perform sequential 10-day courses of daily xylitol and saline irrigations in a randomized fashion, with a 3-day washout irrigation rest period at the start of each treatment arm. Collected data included patient characteristics, along with Sino-Nasal Outcome Test 20 (SNOT-20) and Visual Analog Scale (VAS) scores reported at the beginning and end of each irrigation course.ResultsFifteen of the 20 subjects (75%) returned their SNOT-20 and VAS data for analysis. There was a significant reduction in SNOT-20 score during the xylitol phase of irrigation (mean drop of 2.43 points) as compared to the saline phase (mean increase of 3.93 points), indicating improved sinonasal symptoms (P = .0437). There was no difference in VAS scores. No patient stopped performing the irrigations owing to intolerance of the xylitol, although its sweet taste was not preferred by three subjects (21%). One patient reported transient stinging with xylitol.ConclusionsXylitol in water is a well-tolerated agent for sinonasal irrigation. In the short term, xylitol irrigations result in greater improvement of symptoms of chronic rhinosinusitis as compared to saline irrigation.Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.

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