Chiu Alexander G, Palmer James N, Woodworth Bradford A, Doghramji Laurel, Cohen Michael B, Prince Anthony, Cohen Noam A
Division of Rhinology, Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.
Am J Rhinol. 2008 Jan-Feb;22(1):34-7. doi: 10.2500/ajr.2008.22.3122.
Symptoms of postnasal drainage and thickened mucus are commonly seen in patients with chronic rhinosinusitis (CRS) recalcitrant to sinus surgery and conventional medical therapies. Chemical surfactants can act as a mucolytic by reducing water surface tension and have the potential to serve as an antimicrobial agent. Baby shampoo is an inexpensive, commercially available solution containing multiple chemical surfactants. This is an in vitro study of its antimicrobial effects on Pseudomonas biofilms with translation to a clinical study for use as an adjuvant nasal wash in patients with CRS who remain symptomatic despite adequate sinus surgery and conventional medical therapies.
In vitro testing was performed to determine the optimal concentration of baby shampoo that disrupted preformed bacterial biofilms and inhibited biofilm formation. This concentration was then used in a prospective study of symptomatic post-functional endoscopic sinus surgery (FESS) patients who irrigated twice a day for 4 weeks. Validated outcome forms and objective smell testing was performed before and after therapy.
One percent baby shampoo in normal saline was the optimal concentration for inhibition of Pseudomonas biofilm formation. Baby shampoo had no effect on the eradication of preformed Pseudomonas biofilms. Eighteen patients with CRS with an average of 2.8 surgeries were studied after irrigating with 1% baby shampoo solution. Two patients discontinued use because of minor nasal and skin irritations; 46.6% of patients experienced an overall improvement in their subjective symptoms, and 60% of patients noted improvement in specific symptoms of thickened mucus and postnasal drainage.
Baby shampoo nasal irrigation has promise as an inexpensive, tolerable adjuvant to conventional medical therapies for symptomatic patients after FESS. Its greatest benefit may be in improving symptoms of thickened nasal discharge and postnasal drainage.
鼻后滴漏和黏液增厚的症状在慢性鼻窦炎（CRS）患者中很常见，这些患者对鼻窦手术和传统药物治疗无效。化学表面活性剂可通过降低水的表面张力起到黏液溶解作用，并有潜力作为抗菌剂。婴儿洗发水是一种含有多种化学表面活性剂的廉价商用溶液。这是一项关于其对铜绿假单胞菌生物膜抗菌作用的体外研究，并转化为一项临床研究，用于在鼻窦手术和传统药物治疗充分但仍有症状的CRS患者中作为辅助鼻腔冲洗剂。
进行体外测试以确定破坏预先形成的细菌生物膜并抑制生物膜形成的婴儿洗发水的最佳浓度。然后将该浓度用于对有症状的功能性鼻内镜鼻窦手术（FESS）患者的前瞻性研究，这些患者每天冲洗两次，持续4周。在治疗前后进行经过验证的结果表格和客观嗅觉测试。
生理盐水中1%的婴儿洗发水是抑制铜绿假单胞菌生物膜形成的最佳浓度。婴儿洗发水对消除预先形成的铜绿假单胞菌生物膜没有效果。18例平均接受过2.8次手术的CRS患者在用1%婴儿洗发水溶液冲洗后接受了研究。2例患者因轻微的鼻腔和皮肤刺激而停止使用；46.6%的患者主观症状总体改善，60%的患者指出黏液增厚和鼻后滴漏的特定症状有所改善。
婴儿洗发水鼻腔冲洗有望作为FESS术后有症状患者传统药物治疗的一种廉价、可耐受的辅助治疗方法。其最大益处可能在于改善鼻分泌物增厚和鼻后滴漏的症状。
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