What does this research mean for the field?

Xylitol-containing postoperative nasal irrigations may provide modest symptomatic benefit in selected populations, but current evidence is of low certainty and does not establish a reliable, clinically important advantage over saline. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To evaluate the efficacy and safety of xylitol-containing nasal irrigation or nebulization compared with saline in patients recovering from sinonasal surgery.

August 29, 2026Clinical Otolaryngology

Xylitol‐Containing Nasal Irrigation or Nebulization in Postoperative Sinonasal Care: A Systematic Review and Meta‐Analysis With GRADE Assessment

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Authors

MRMohamed Saad RakabMansoura University YAYasir Majhud S. AlzahraniAl Baha University AAAbdulaziz Muhayya AlotaibiQassim University

Discussion

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Implication

A systematic review and meta-analysis finds modest symptom relief but uncertain clinical benefit from xylitol rinses after sinus surgery, suggesting routine use requires stronger evidence.

Key Points

To evaluate the efficacy and safety of xylitol-containing nasal irrigation or nebulization compared with saline in patients recovering from sinonasal surgery.
Systematic review and random-effects meta-analysis searching PubMed, Scopus, Web of Science, and CENTRAL from inception through June 2026.
Identified 8 comparative studies evaluating xylitol-containing nasal solutions versus saline following endoscopic sinus surgery, septoplasty, or turbinate surgery.
Evaluated patient-reported symptom scores (SNOT-20/22, NOSE, VAS), endoscopic healing, and safety using the GRADE approach.
Xylitol demonstrated no significant overall benefit on SNOT-20/22 scores (SMD −0.49, 95% CI −1.12 to 0.14; p = 0.107), though sensitivity analysis excluding one study significantly favored xylitol (SMD −0.27, 95% CI −0.47 to −0.06; p = 0.0098).
VAS scores showed modest but statistically significant symptom improvement with xylitol (MD −1.16 points, 95% CI −2.30 to −0.03; p = 0.045), whereas NOSE scores showed no overall advantage (MD −4.18, 95% CI −13.04 to 4.68; p = 0.2299).
Endoscopic healing scores did not differ significantly between xylitol and saline groups (SMD −0.21, 95% CI −0.51 to 0.08; p = 0.1157), with overall certainty of evidence rated as low to very low.

Cite This Study

Rakab et al. (2026) studied this question.

synapsesocial.com/papers/6a9299bb8e5d7d1fc0c11d16 https://doi.org/10.1111/coa.70155

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Implication

A systematic review and meta-analysis finds modest symptom relief but uncertain clinical benefit from xylitol rinses after sinus surgery, suggesting routine use requires stronger evidence.