Nasal Saline Rinses Reduce Ear Infections in Kids

FRIDAY April 30, 2010 -- Rinsing the nasal cavity with a saline solution has become a popular way to try to reduce allergy symptoms and sinus infections in adults, and now a new study suggests that this simple treatment might also help prevent ear infections in young children.

In the small Canadian study, 10 children who received an average of four nasal irrigations four days a week had no ear infections during the three-month study period, while only three of those who weren't given nasal washes had no ear infections.

"Saline irrigations are simple, low-cost and have few, if any, side effects," the study authors wrote. "Our results suggest that nasal irrigations could effectively prevent recurrent otitis media."

Otitis media is the medical term for ear infections. Such infections are the leading cause of hearing loss in children, according to the study. Standard treatment for bacterial ear infections is antibiotics. However, there's growing concern that repeatedly using antibiotics to treat ear infections might lead to antibiotic resistance.

In an effort to find an alternative to antibiotics, researchers from Sainte-Justine Hospital in Montreal reviewed the data on saline nasal rinses in adults and discovered that irrigating the nasal cavity can reduce nasal swelling and discharge after surgery and that nasal irrigation is often being used to reduce sinus symptoms in adults.

"The idea behind a saline rinse for ear infections is that you have a lot of germs in the back of your nose and throat where the Eustachian tube connects. If you can wash out those germs on a regular basis, you could potentially reduce the number of ear infections," explained Dr. Richard Rosenfeld, chair of otolaryngology at Long Island College Hospital in New York City and the editor of the journal Otolaryngology - Head and Neck Surgery.

To see if saline irrigation would have a positive effect on the rate of ear infections, the researchers recruited 29 children between the ages of 6 months and 5 years who had been referred to the otolaryngology clinic at Sainte-Justine Hospital because of recurrent ear infections.

Seventeen of the children were randomly selected to be in the nasal rinse treatment group. Parents were instructed on how to properly irrigate their children's nasal cavities, and were asked to perform the nasal rinse at least four times a day, four days a week. According to the study, all of those in the treatment group performed the nasal irrigations as specified by the researchers.

After three months, the researchers found that five children who weren't treated experienced two or more ear infections, while no youngsters in the treatment group had two or more infections. Four kids in the control group had just one ear infection while seven in the treatment group had one infection. Only three children in the control group didn't have an ear infection, compared to 10 in the treated group.

Overall, youngsters in the control group experienced an average of just over one ear infection a month vs. 0.35 infections per month in the treatment group.

"Ear infections were much less likely in the treatment group, but this is a pretty small study," said Rosenfeld, who was also concerned that kids in the control group had more risk factors for getting ear infections.

"The group that was not treated had a much higher rate of day-care attendances, they were younger, there were more boys, they had an earlier onset of ear infections and they used pacifiers more. Every one of those things is a risk factor for ear infections on their own," he said.

"So, did the treatment group have fewer infections because the saline worked, or because those kids have less risk to begin with?" wondered Rosenfeld.

"It's a good idea that may or may not pan out, but the evidence is not convincing at present," he said.

Still, "I think if parents are interested, this is something they could try. It's relatively simple, cost-effective and has few side effects," explained Dr. Franklin Smalley, a family medicine doctor with Scott and White Healthcare in Taylor, Texas.

Smalley said that parents should ask their child's doctors to demonstrate the proper technique, however. He said the over-the-counter products designed for adults, such as saline sprays, may have too much pressure for small children.

The finding is scheduled to be presented Friday at the American Society of Pediatric Otolaryngology annual meeting in Las Vegas.

More information

Learn more about ear infections from the National Institute on Deafness and Other Communication Disorders.

Posted: April 2010


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