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Abstract Upper respiratory tract infections, rhinosinusitis, and allergic rhinitis are among the most frequent reasons for visits to primary care physicians and are the leading causes of absenteeism in the United States (Tomooka et al, 2000). Nasal irrigation is a simple and inexpensive treatment which relieves the symptoms of a variety of sinus and nasal conditions (including infectious and allergic entities). Isotonic saline was first introduced for nasal irrigation, while hypertonic saline has recently been popularised as it has been found to decrease oedema and improve mucociliary clearance (Ural et al, 2009). Many scientific studies have been published proving its beneficial effects on clearing secretions, as well as its positive effects on the elimination of symptoms and improving the quality of life for its users (Friedman et al, 2006). There has been increasing use of saline irrigation, douches, sprays and rinsing as an adjunct to the medical management of chronic rhinosinusitis. Treatment strategies often include the use of topical saline from once to more than four times a day (Harvey et al, 2007). Hypertonic saline nasal irrigation (HSNI) is an adjunctive therapy for rhinosinusitis and sinus symptoms. It flushes the nasal cavity, facilitating the evacuation of potentially allergen- and irritant-containing mucus (Rabago et al, 2008). The Potential efficacy is supported by the Observation that hypertonic saline improves mucociliary clearance, thins mucus, and may decrease inflammation (Rabago et al, 2002). summary 90 The mechanical clearance of mucus is commonly proposed as the sole basis of its benefit. However, there is an increasing perception that saline has a contributory role in the resolution of inflammation and does not just relieve symptoms for mechanical reasons (Harvey et al, 2007). Harvey et al., 2007, Lance et al., 2009, URAL et al., 2009, Hauptman and Ryan in 2007, Adam et al., 1998 and Farag et al., 2013, found that there are no significant differences in overall subjective symptoms related to sinonasal disease between isotonic Saline and hypertonic saline irrigation. While Shoseyov et al., 1998, Rabago et al., 2002, Rabago et al., 2006, David et al., 2008, Friedman et al., 2012, Alice and Satish, 2013 and Martin et al., 2007, found that there is Some evidence suggests that hypertonic solutions improve objective measures and hypertonic saline is recommended over isotonic solution. As conculsion nasal irrigation using hypertonic solution was tested against other saline soulation to treat symptoms of rhinosinusitis that hypertonic solution is superior to saline in reduction of symptoms and improvement of the quality of life |