Nasal Irrigation:

The nasal and sinus cavities are normally able to clear mucus on their own through a process called “mucociliary transport.” Up to one quart of mucus is produced daily, and sometimes swelling of the nose caused by allergies, irritation, and/or infection prevents this self-clearing of mucus. In these cases, saline irrigations are used to help clear secretions and debris and assist in mucociliary transport.

Irrigation Devices:

Irrigations may be performed using devices such as a Sinus Rinse^® bottle, a neti pot, or other irrigation devices which can be purchased at your local pharmacy. It is important to sterilize the apparatus on a routine basis so that bacteria are not reintroduced into the nasal or sinus cavities during subsequent irrigation. This can be done by submerging the device in boiling water for 10 minutes or by placing it on the top rack of your dishwasher.

Irrigation Solutions:

A variety of solutions can be used, depending on the nature and degree of material that needs to be cleared from the nose.

• At Home: You can prepare saline irrigations at home by mixing one teaspoon of sea salt or Kosher salt (not table salt) and one teaspoon of baking soda into one quart of distilled water or boiled tap water. You may also purchase pre-mixed packets at your local pharmacy to mix with distilled water or boiled tap water.
• Prescription: Your doctor may prescribe medications that can be added to the irrigation solution. Budesonide is a steroid that is added to an irrigation solution by you. Antibacterial (e.g. Tobramycin, Gentamicin) or antifungal (e.g. Amphotericin-B) agents to inhibit bacterial or fungal growth, respectively, are added to an irrigation by your pharmacist.

Instructions:

1. Tip your head forward and towards one shoulder while inserting the irrigation device into to the opposite nostril (e.g. insert irrigation device into left nostril and tip head forward and towards right shoulder).
2. When irrigating the nose, the solution will run out the front of your nose or down the back of your throat. Irrigations should be performed while leaning forward over a sink or in the shower so that the solution may drip out or be spit out.
3. To prevent injury, take the tip of the irrigating device out of your nose if you must cough or sneeze.
4. Avoid speaking/swallowing during irrigations. This can change the pressure in your nose and/or ears, causing infected mucus to be drawn into the sinuses or middle ear spaces.

Other Helpful Ideas:

• Humidifiers can also be helpful for treatment of sinusitis, as they thin mucous secretions. Dryness inside the nose is seen as an irritant and may cause the nose to swell. It is important to clean humidifiers on a regular basis. However, patients with allergies should keep humidity in the home less than 50% to prevent mold from growing.
• Drink water – you should drink a minimum of eight, 8oz glasses of water per day; this helps keep the body and mucous membranes hydrated.
• Avoid alcohol – alcohol may worsen sinusitis because it dehydrates the body and may interfere with effective absorption of some medications.
• Avoid smoking – cigarette smoke contains numerous chemicals and irritants that directly damage the nasal mucous membranes.