اثر آنتی باکتریال محلول هیپوکلرو اسید بر ترشح بینی در بیماران مبتلا به رینو سینوزیت مزمن Antibacterial Effect of Hypochlorous Acid Solution on Nasal Discharge from Patients with Chronic Rhinosinusitis

1. Introduction Hypochlorous acid (HOCl) is a weak acid which is produced when chlorine dissolves in water [1]. It can be generated by the electrolysis of a weak sodium chloride solution [2]. It has been demonstrated to have bactericidal effects [1]. Recently, HOCl solution has been used as nasal irrigant to treat pediatric chronic sinusitis [3]. Povidone-iodine (PVPI) solution is a potent antimicrobial solution [4]. Its advantages include broad dismicrobial spectrum, low cost, low risk for sensitization, and lack of bacterial resistance against the agent [5]. It has been used as mouthwash for many purposes [4]. Nasal irrigation is a popular treatment modality for various sinonasal diseases including upper respiratory tract infection, rhinitis, rhinosinusitis, and postoperative or postradiation care [6–10]. While nasal irrigation has been widely used, there is no consensus on the optimal irrigation solution [11–13]. Saline irrigation is mostly acceptable. Antimicrobial agents as antibiotics or antifungal agents had been added to the irrigation fluid [14–16]. Some researchers had also used additives as manuka honey, xylitol, or surfactant for improvement of the effect of nasal irrigation [17]. In the present work, the antibacterial effect of HOCL on the nasal secretion of CRS patients was investigated to clarify its role as nasal irrigant. 2. Materials and Methods This study was approved by the Ethics Committee of Taichung Veterans General Hospital. Written consent was obtained from each patient. 2.1. Study Population. A total of 82 CRS patients were collected from the outpatient clinic of the Department of Otolaryngology between September of 2015 and April of 2016. CRS was diagnosed when patients had a history of rhinosinusitis for more than 12 weeks and the nasal endoscopy found mucopurulent discharge in the nasal cavity. Those who took antibiotics within a week before were excluded from the study.