Abstract:

Chronic suppurative rhinosinusitis (CSRS) in patients with type II diabetes mellitus poses significant therapeutic challenges due to impaired mucociliary clearance, reduced local immunity, and delayed tissue healing. Phytotherapy using walnut (Juglans regia) tincture offers a promising adjunctive modality. This expanded study examines the pharmacological rationale, preparation protocol, dosage justification, clinical outcomes, and safety profile of walnut tincture nasal irrigations in diabetic CSRS patients. A randomized trial of 80 subjects demonstrated that twice-daily irrigation with a 1:20 walnut‐tincture solution for 14 days resulted in a 85 % reduction in purulent discharge, 80 % improvement in nasal airflow, and marked enhancement of mucosal regeneration compared with standard therapy alone. No serious adverse events were recorded. Our findings support incorporation of walnut tincture irrigation into CSRS management algorithms for diabetic patients.