Casale Manuele has completed his PhD at the age of 33 years from Campus Bio-Medico University of Rome, Italy and a fellowship from University of Navarra, School of Medicine, Pamplona, Spain. He is the Assistant Professor of Otolaryngology Department of Campus Bio-Medico University of Rome. He has published more than 65 papers in reputed international journals and serving as an Editorial Board Member of repute.


This study was designed to prospectively evaluate the role of nebulized hyaluronic acid (HA) given for 10 days/mo over 3 months as adjunct treatment to minimize symptoms and preventing exacerbation of chronic rhinosinusitis (CRS). Thirty-nine eligible patients were randomized to receive nebulized 9-mg sodium hyaluronate nasal washes plus saline solution (21 patients) or 5 mL of saline alone (18 patients), according to an open-label, parallel-group design, with blind observer assessment. A questionnaire about main CRS discomfort and nasal endoscopy for mucous discharge and/or mucosal edema of nasal cavities was used to assess primary outcomes of treatments. Secondary outcome measures included side effects and satisfaction. HA significantly improved quality of life in CRS patients according to the CRS questionnaire (16±3.72 versus 11.52±4.28; p<0.001), contrary to saline group scores (18.92±3.09 versus 18.21±3.21; p<0.55). The HA group showed significantly reduced osteomeatal edema (2.42 versus 1.52; p<0.001) and secretions (0.95 versus 0.42; p<0.001), whereas there was no statistically significant difference in the saline group. The compliance to the treatment was similar in both groups and no side effects were recorded. The results of this study suggested that intermittent treatment with topical 9-mg sodium hyaluronate plays a role in minimizing symptoms and could prevent exacerbations of CRS.

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