The Editorial Executive Committee welcomes letters, which should be less than 250 words. Before a decision to publish is made, letters which refer to a published article may be sent to the author for a response. Any letter may be sent to an expert for comment. When letters are published, they are usually accompanied in the same issue by their responses or comments. The Committee screens out discourteous, inaccurate or libellous statements. The letters are sub-edited before publication. Authors are required to declare any conflicts of interest. The Committee's decision on publication is final.

Letter to the Editor

After reading Chris Del Mar’s article on acute sinusitis and sore throat,1 I would like to ask him if there is evidence for the commonest treatments that ear, nose and throat surgeons use for sinusitis. These include oral or topical steroids plus saline nasal rinses.

Bridget Clancy
Ear, nose, throat, head and neck surgeon
Warrnambool, Victoria

Author's comments

Chris Del Mar, the author of the article, comments:

A Cochrane review of four randomised trials and 1943 patients indicates that intranasal steroids at high doses do provide some relief of acute sinusitis, although only for mild disease, and with a number needed to treat of about 12.1 Another Cochrane review of five randomised trials with a total of 1193 adults found no benefit for systemic steroids in acute sinusitis.2

A third Cochrane review of acute respiratory infections included 749 children and adults in five randomised controlled trials. Participants were randomised to saline nasal washouts or not. The trials had such mixed results (heterogeneity) that they could not be pooled, and were sufficiently vulnerable to bias that any benefits were deemed unreliable.3 Combinations of these interventions have not been studied in Cochrane reviews.