Efficacy and safety of negative-pressure nasal irrigation in pediatric chronic rhinosinusitis: A retrospective cohort study.

Background

Pediatric chronic rhinosinusitis (CRS) affects 6.37% of Chinese children. Negative-pressure nasal irrigation (NNPI) is recommended by Chinese guidelines, but international evidence remains limited.

Objective

To evaluate efficacy and safety of NNPI combined with standard medical therapy in pediatric CRS.

Methods

Retrospective cohort study of 200 children (3-6 years) with CRS. One hundred children receiving NNPI plus standard therapy were matched with 100 receiving standard therapy alone for 14 days. All children were treatment-naïve to intranasal corticosteroids and nasal irrigation within one month prior to enrollment. Primary outcomes were symptom score changes.

Results

After 14 days, NNPI group showed greater reductions in cough (1.10 ± 0.30 vs. 1.96 ± 0.86; P < 0.001), nasal obstruction (1.62 ± 1.19 vs. 1.97 ± 1.05; P = 0.028), and rhinorrhea (1.15 ± 0.46 vs. 1.97 ± 1.05; P < 0.001). Total effective rate was higher (90.0% vs. 75.0%; P = 0.005). Adverse events were mild (9.0% vs. 3.0%; P = 0.074). No instances of respiratory distress, aspiration, or procedure intolerance occurred.

Conclusions

NNPI combined with standard therapy significantly improves efficacy in pediatric CRS with good safety. However, given the lack of a conventional irrigation control group and the short follow-up period, these findings should be interpreted cautiously and warrant validation in prospective studies with longer observation.