The effectiveness of topical colloidal silver in recalcitrant chronic rhinosinusitis: a randomized crossover control trial

Abstract Background Recalcitrant chronic rhinosinusitis without polyposis (CRSsP) is a challenging condition to manage as traditional medical therapies and surgery fail to provide satisfactory clinical improvements. Colloidal silver (CS), a widely used naturopathic agent, has recently shown anti-bio...

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Main Authors: John R. Scott, Rohin Krishnan, Brian W. Rotenberg, Leigh J Sowerby
Format: Article
Language:English
Published: SAGE Publishing 2017-11-01
Series:Journal of Otolaryngology - Head and Neck Surgery
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Online Access:http://link.springer.com/article/10.1186/s40463-017-0241-z
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author John R. Scott
Rohin Krishnan
Brian W. Rotenberg
Leigh J Sowerby
author_facet John R. Scott
Rohin Krishnan
Brian W. Rotenberg
Leigh J Sowerby
author_sort John R. Scott
collection DOAJ
description Abstract Background Recalcitrant chronic rhinosinusitis without polyposis (CRSsP) is a challenging condition to manage as traditional medical therapies and surgery fail to provide satisfactory clinical improvements. Colloidal silver (CS), a widely used naturopathic agent, has recently shown anti-biofilm properties both in vitro and within a rhinosinusitis animal model. To date, no trials involving humans have been published in world literature. The purpose of this study was to assess the efficacy of CS as a topical nasal spray in patients with refractory CRSsP. Methods A prospective cohort study was conducted using a convenience sample of 20 randomized patients with crossover methodology, comparing nasal sprays with CS versus saline. Patients sprayed twice daily for six weeks with the first intervention and then switched to the second for the next six weeks, with measurements made at baseline and each time point. Primary outcomes were changes in SNOT-22 and Lund-Kennedy (LK) endoscopic scores. All analysis was non-parametric and was conducted using STATA 14. Results Twenty-two patients were enrolled in the study with 20 completing the entire protocol. Mean 6-week change in SNOT-22 scores were −2.8 and 1.0 for saline and CS, respectively (p = 0.373). Similarly, mean 6-week change in LK scores were −1.4 and −1.1 for saline and CS, respectively (p = 0.794). Significant period effects were observed with the SNOT-22 score between the randomized groups. No participants experienced negative health effects directly attributable to the administration of intranasal CS. Conclusion Commercially available CS nasal spray did not demonstrate any meaningful subjective or objective improvements in patients with recalcitrant CRSsP. Trial registration NCT02403479 . Registered on March 1, 2015.
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spelling doaj-art-21e58f57e8b6482ea6fca9312ebc8e622025-08-20T03:54:42ZengSAGE PublishingJournal of Otolaryngology - Head and Neck Surgery1916-02162017-11-014611610.1186/s40463-017-0241-zThe effectiveness of topical colloidal silver in recalcitrant chronic rhinosinusitis: a randomized crossover control trialJohn R. Scott0Rohin Krishnan1Brian W. Rotenberg2Leigh J Sowerby3Department of Otolaryngology, Head and Neck Surgery, Schulich School of Medicine and Dentistry, Western UniversityDepartment of Otolaryngology, Head and Neck Surgery, Schulich School of Medicine and Dentistry, Western UniversityDepartment of Otolaryngology, Head and Neck Surgery, Schulich School of Medicine and Dentistry, Western UniversityDepartment of Otolaryngology, Head and Neck Surgery, Schulich School of Medicine and Dentistry, Western UniversityAbstract Background Recalcitrant chronic rhinosinusitis without polyposis (CRSsP) is a challenging condition to manage as traditional medical therapies and surgery fail to provide satisfactory clinical improvements. Colloidal silver (CS), a widely used naturopathic agent, has recently shown anti-biofilm properties both in vitro and within a rhinosinusitis animal model. To date, no trials involving humans have been published in world literature. The purpose of this study was to assess the efficacy of CS as a topical nasal spray in patients with refractory CRSsP. Methods A prospective cohort study was conducted using a convenience sample of 20 randomized patients with crossover methodology, comparing nasal sprays with CS versus saline. Patients sprayed twice daily for six weeks with the first intervention and then switched to the second for the next six weeks, with measurements made at baseline and each time point. Primary outcomes were changes in SNOT-22 and Lund-Kennedy (LK) endoscopic scores. All analysis was non-parametric and was conducted using STATA 14. Results Twenty-two patients were enrolled in the study with 20 completing the entire protocol. Mean 6-week change in SNOT-22 scores were −2.8 and 1.0 for saline and CS, respectively (p = 0.373). Similarly, mean 6-week change in LK scores were −1.4 and −1.1 for saline and CS, respectively (p = 0.794). Significant period effects were observed with the SNOT-22 score between the randomized groups. No participants experienced negative health effects directly attributable to the administration of intranasal CS. Conclusion Commercially available CS nasal spray did not demonstrate any meaningful subjective or objective improvements in patients with recalcitrant CRSsP. Trial registration NCT02403479 . Registered on March 1, 2015.http://link.springer.com/article/10.1186/s40463-017-0241-zColloidal silverChronic rhinosinusitisRecalcitrantEffectivenessNasal sprayTopical
spellingShingle John R. Scott
Rohin Krishnan
Brian W. Rotenberg
Leigh J Sowerby
The effectiveness of topical colloidal silver in recalcitrant chronic rhinosinusitis: a randomized crossover control trial
Journal of Otolaryngology - Head and Neck Surgery
Colloidal silver
Chronic rhinosinusitis
Recalcitrant
Effectiveness
Nasal spray
Topical
title The effectiveness of topical colloidal silver in recalcitrant chronic rhinosinusitis: a randomized crossover control trial
title_full The effectiveness of topical colloidal silver in recalcitrant chronic rhinosinusitis: a randomized crossover control trial
title_fullStr The effectiveness of topical colloidal silver in recalcitrant chronic rhinosinusitis: a randomized crossover control trial
title_full_unstemmed The effectiveness of topical colloidal silver in recalcitrant chronic rhinosinusitis: a randomized crossover control trial
title_short The effectiveness of topical colloidal silver in recalcitrant chronic rhinosinusitis: a randomized crossover control trial
title_sort effectiveness of topical colloidal silver in recalcitrant chronic rhinosinusitis a randomized crossover control trial
topic Colloidal silver
Chronic rhinosinusitis
Recalcitrant
Effectiveness
Nasal spray
Topical
url http://link.springer.com/article/10.1186/s40463-017-0241-z
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