Hyaluronic Acid Effects on Impaired Mucociliary Clearance Due to Radiotherapy

Objective: This study aims to determine whether there is any effect of hyaluronic acid-containing nasal wash solutions in patients with impaired mucociliary clearance after radiotherapy. Methods: Patients who received radiotherapy to nasopharynx and neck region due to nasopharynx cancer were included in this study. None of the patients received chemotherapy. The study was divided into 2 groups, A and B. Group B was the control group. There were 17 (40%) females, 33 (60%) males, totally 50 patients in group A and 12 (45%) females and 18 (55%) males, totally 30 patients in group B. One-fourth of the grain saccharin tablet was placed to the lateral part of the anterior end of inferior turbinate of the patients and they were asked to swallow every 30 seconds. The clearance time was determined by the first time the sugar was tasted. Mucociliary clearance records of the patients in group A were obtained every day after nasal irrigation with saline for 7 days. Then, the mucociliary clearance of these patients was also measured by using saline+ hyaluronic acid nasal irrigation solution as well. Nasal irrigation containing hyaluronic acid was used for 7 days 3 times a day and each time 100 mL of irrigant liquid was used. Mucociliary clearance was measured without using any irrigation solution in group B. Results: Before the administration of nasal wash solution with hyaluronic acid, the mean mucociliary clearance time for male patients was 26.4 minutes (range, 8-45 minutes), and the mean mucociliary clearance duration for female patients was 21.8 minutes (range, 7-33 minutes). After the administration of nasal wash with hyaluronic acid, the mean mucociliary clearance duration time of the male patients was 21 minutes (range, 7-35 minutes), and it was 17.8 minutes (range, 7-30 minutes) minutes for female patients. This finding was significantly reduced in both female (P=.001) and men (P < .001) patients. Conclusion: In our study, we found that hyaluronic acid-containing nasal wash solutions affect mucociliary clearance time positively. These results contribute to cope with radiotherapy post-effects in a cost-effective and non-invasive way. Simple solutions may increase the quality of life in such patients.