Nasal irrigations: Good or bad?

Current Opinion in Otolaryngology and Head and Neck Surgery

Volumn 12, Issue 1, 2004, Pages 9-13

  Brown, Christopher L ^a   Graham, Scott M ^a  

^a UNIVERSITY OF IOWA HOSPITALS AND CLINICS   (United States)

Author keywords

Nasal irrigation; Rhinitis; Saline; Sinusitis

Indexed keywords

AMPHOTERICIN B; ANTIFUNGAL AGENT; ANTIINFECTIVE AGENT; BUFFER; CLOTRIMAZOLE; GENTAMICIN; HYDROGEN PEROXIDE; ITRACONAZOLE; POVIDONE IODINE; PSEUDOMONIC ACID; RINGER SOLUTION; SODIUM CHLORIDE; TOBRAMYCIN; XYLITOL;

CHRONIC SINUSITIS; HUMAN; INFECTION RATE; INTERMETHOD COMPARISON; LAVAGE; MEDICAL INSTRUMENTATION; NEBULIZER; NOSE; NOSE DISEASE; OUTCOMES RESEARCH; PARANASAL SINUS DISEASE; PATIENT; PH; PRESSURE; PRIORITY JOURNAL; REVIEW; RHINOSINUSITIS; SAFETY; SYMPTOM; TREATMENT INDICATION;

HUMANS; IRRIGATION; PARANASAL SINUS DISEASES; TREATMENT OUTCOME;

EID: 1642520707     PISSN: 10689508     EISSN: None     Source Type: Journal    
DOI: 10.1097/00020840-200402000-00004     Document Type: Review

References (39)

1. Ray NF, Baraniuk JN, Thamer M, et al.: Healthcare expenditures for sinusitis in 1996: contributions of asthma, rhinitis, and other airway disorders. J Allergy Clin Immunol 1999, 103:408-414.
2. Papsin B, McTavish A: Saline nasal irrigation: its role as an adjunct treatment. Can Fam Physician 2003, 49:168-273. This is a good review of the indications for using nasal irrigations.
3. Lanza DC, Kennedy DW: Adult rhinosinusitis defined. Otolaryngol Head Neck Surg 1997, 117:S1-S7.
4. Heatley DG, McConnell KE, Kille TL, et al.: Nasal irrigation for the alleviation of sinonasal symptoms. Otolaryngol Head Neck Surg 2001, 125:44-48.
5. Kaliner MA, Osguthorpe JD, Fireman P, et al.: Sinusitis: bench to bedside. Current findings, future directions. Otolaryngol Head Neck Surg 1997, 116:S1-S20.
6. Hamilos DL: Chronic sinusitis. J Allergy Clin Immunol 2000, 106:213-227.
7. Subramanian HN, Schechtman KB, Hamilos DL: A retrospective analysis of treatment outcomes and time to relapse after intensive medical treatment for chronic sinusitis. Am J Rhinol 2002, 16:303-312. This is a good review reporting that medical management is usually effective in managing chronic sinusitis.
8. Benninger MS, Anon J, Mabry RL: The medical management of rhinosinusitis. Otolaryngol Head Neck Surg 1997, 117:S41-S9.
9. Talbot AR, Herr TM, Parsons DS: Mucociliary clearance and buffered hypertonic saline solution. Laryngoscope 1997, 107:500-503.
10. Rabago D, Zgierska A, Mundt M, et al.: Efficacy of daily hypertonic saline nasal irrigation among patients with sinusitis: a randomized controlled trial. J Fam Pract 2002, 51:1049-1055. This study demonstrates that hypertonic saline nasal irrigations are effective in reducing symptoms.
11. Tomooka LT, Murphy C, Davidson TM: Clinical study and literature review of nasal irrigation. Laryngoscope 2000, 110:1189-1193.
12. Primer on allergic and immunologic diseases. JAMA 1997, 278:1803-2030.
13. Georgitis JW: Nasal hyperthermia and simple irrigation for perennial rhinitis. Changes in inflammatory mediators. Chest 1994, 106:1487-1492.
14. Moore EJ, Kern EB: Atrophic rhinitis: a review of 242 cases. Am J Rhinol 2001, 15:355-361.
15. Seppey M, Schweri T, Hausler R: Comparative randomised clinical study of tolerability and efficacy of Rhinomer Force 3 versus a reference product in post-operative care of the nasal fossae after endonasal surgery. ORL J Otorhinolaryngol Relat Spec 1996, 58:87-92.
16. Shoseyov D, Bibi H, Shai P, et al.: Treatment with hypertonic saline versus normal saline nasal wash of pediatric chronic sinusitis. J Allergy Clin Immunol 1998, 101:602-605.
17. Ponikau JU, Sherris DA, Kern EB, et al.: The diagnosis and incidence of allergic fungal sinusitis. Mayo Clin Proc 1999, 74:877-884.
18. Carothers DG, Graham SM, Jia HP, et al.: Production of β-defensin antimicrobial peptides by maxillary sinus mucosa. Am J Rhinol 2001, 15:175-179.
19. Ghafouri B, Stahlbom B, Tagesson C, et al.: Newly identified proteins in human nasal lavage fluid from non-smokers and smokers using two-dimensional gel electrophoresis and peptide mass fingerprinting. Proteomics 2002, 2:112-120.
20. Boek WM, Graamans K, Natzijl H, et al.: Nasal mucociliary transport: new evidence for a key role of ciliary beat frequency. Laryngoscope 2002, 112:570-573.
21. Boek WM, Keles N, Graamans K, et al.: Physiologic and hypertonic saline solutions impair ciliary activity in vitro. Laryngoscope 1999, 109:396-399.
22. Toskala E, Nuutinen J, Rautiainen M: Scanning electron microscopy findings of human respiratory cilia in chronic sinusitis and in recurrent respiratory infections. J Laryngol Otol 1995, 109:509-514.
23. Bolger WE, Leonard D, Dick EJ Jr, et al.: Gram negative sinusitis: a bacteriologic and histologic study in rabbits. Am J Rhinol 1997, 11:15-25.
24. Nuutinen J, Rauch-Toskala E, Saano V, et al.: Ciliary beating frequency in chronic sinusitis. Arch Otolaryngol Head Neck Surg 1993, 119:645-647.
25. Inanli S, Oturk O, Korkmaz M, et al.: The effects of topical agents of fluticasone propionate, oxymetazoline, and 3% and 0.9% sodium chloride solutions on mucociliary clearance in the therapy of acute bacterial rhinosinusitis in vivo. Laryngoscope 2002, 112:320-325.
26. Unal M, Gorur K, Ozcan C: Ringer-lactate solution versus isotonic saline solution on mucociliary function after nasal septal surgery. J Laryngol Otol 2001, 115:796-797.
27. Valente JH, Forti RJ, Freundlich LF, et al.: Wound irrigation in children: saline solution or tap water? Ann Emerg Med 2003, 41:609-616. This interesting article challenges the need for sterile wound irrigations in pediatric patients, with obvious relevance to nasal irrigations.
28. Luk CK, Dulfano MJ: Effect of pH, viscosity and ionic-strength changes on ciliary beating frequency of human bronchial explants. Clin Sci (Lond) 1984, 64:449-451.
29. Homer JJ, England RJ, Wilde AD, et al.: The effect of pH of douching solutions on mucociliary clearance. Clin Otolaryngol 1999, 24:312-315.
30. England RJ, Anthony R, Homer JJ, et al.: Nasal pH and saccharin clearance are unrelated in the physiologically normal nose. Rhinology 2000, 38:66-67.
31. Deleted in proof.
32. Vaughan WC, Carvalho G: Use of nebulized antibiotics for acute infections in chronic sinusitis. Otolaryngol Head Neck Surg 2002, 127:558-568.
33. Graham SM, Launspach JL, Welsh MJ, et al.: Sequential magnetic resonance imaging analysis of the maxillary sinuses: implications for a model of gene therapy in cystic fibrosis. J Laryngol Otol 1999, 113:329-335.
34. Ponikau JU, Sherris DA, Kita H, et al.: Intranasal antifungal treatment in 51 patients with chronic rhinosinusitis. J Allergy Clin Immunol 2002, 110:862-866. This controversial article discusses the use of amphotericin B in chronic sinusitis. Notably, no control was used.
35. Ricchetti A, Landis BN, Maffioli A, et al.: Effect of anti-fungal nasal lavage with amphotericin B on nasal polyposis. J Laryngol Otol 2002, 116:261-263.
36. Gosepath J, Grebneva N, Mossikhin S, et al.: Topical antibiotic, antifungal, and antiseptic solutions decrease ciliary activity in nasal respiratory cells. Am J Rhinol 2002, 16:25-31.
37. Zabner J, Seiler MP, Launspach JL, et al.: The osmolyte xylitol reduces the salt concentration of airway surface liquid and may enhance bacterial killing. Proc Natl Acad Sci U S A 2000, 97:11614-11619.
38. Grossan M: Nasal irrigation. Laryngoscope 2001, 111:1867-1869.
39. Olson DE, Rasgon BM, Hilsinger RL Jr: Radiographic comparison of three methods for nasal saline irrigation. Laryngoscope 2002, 112:1394-1398. This is a good review of difference nasal irrigation methods and their relative effectiveness.