In medicine, “irrigate” means to rinse out and clean with a liquid. Irrigation of the nose is an ancient technique supported by modern science. A mix of salt and water (“saline”) is used to wash the nasal cavity regularly. This helps to rinse out bacteria, viruses, allergy particles, and other debris. Studies have shown this can lessen inflammation and improve nasal symptoms. When done correctly, nasal rinses are a safe, effective, and affordable way to help treat and reduce sinus problems.
There are different methods for performing nasal saline irrigations, and not all are equally effective in reaching the entire nasal cavity. Studies have shown that using larger amounts of saline to rinse the nose is more effective in improving symptoms.
There are many sinus irrigation devices on the market today that you can choose from to
irrigate your sinuses. Or you can keep it simple and use a bulb syringe.
The key to nasal irrigations is understanding the anatomy of your sinuses.
Nasal Irrigations
Saline Concentration
A common recipe is one teaspoon of Sea Salt (iodine-free salt), one teaspoon of baking soda, mixed with 2 cups of warm sterile water. Many companies offer premixed salt packets for easy use.
Irrigation Device Contamination
Because nasal irrigations are often used to treat infection, keeping the device clean is very important. Devices can carry bacteria into the nose if not cleaned after use.
Water Source
There have been a few cases in the news of patients dying from a serious brain infection after using nasal rinses made with tap water. The cause is a tiny amoeba called Naegleria fowleri, which is commonly found in rivers and lakes (this is why infection has also been reported after swimming in freshwater). Naegleria can rarely get into the water supply, and to be safe, tap water should not be used for nasal saline irrigations unless it is first boiled and allowed to cool. Using distilled water is another safe option.
Medicated Irrigations
Nasal irrigations can also be used to deliver medications like steroids or antibiotics directly to the sinuses. Studies have shown that adding a steroid medicine to high-volume saline rinses is well tolerated and can help to improve sinus symptoms in many patients. Research continues to improve our understanding of the optimal use of topical antibiotics and steroid rinses in the treatment of sinusitis.
High-volume nasal saline irrigations, when performed correctly, are safe and can help improve sinus symptoms. Proper cleaning and choosing the right water source are critical to preventing contamination. Placing medications into saline irrigations may be an effective way of treating some patients with sinusitis.
Sinus Anatomy
Your sinuses are four paired cavities in your face. They include the frontal, sphenoid, ethmoid, and maxillary sinuses. Together, they form a mucus drainage system that empties into your nasal cavity, keeping it free from germs and allergens.
Frontal Sinus: Frontal sinuses are in your forehead area, above your eyebrows. Inflammation and infection in the frontal sinuses cause pain in your forehead.
Sphenoid Sinus: The sphenoid sinuses are behind your eyes. Of all your sinuses, it's the one deepest inside your head. Inflammation and infection in the sphenoid sinuses cause pain behind your eyes or in your ears.
Ethmoid Sinus: Ethmoid sinuses are between your eyes, behind the bridge of your nose. The ethmoid sinus cavity consists of many tiny cavities (or pockets) called air cells. Inflammation and infection in the ethmoid sinuses cause pain in the bridge of your nose.
Maxillary Sinus: Maxillary sinuses are located below your eyes, on either side of your nose. They are the largest of the sinuses and the most common site for a sinus infection to start. Inflammation and infection in the maxillary sinuses cause pain in your cheeks and/or your upper teeth.
Your sinuses drain into multiple passages that lead to your nasal cavity. Although not a sinus, the Osteomeatal Complex is important. It is the pathway that drains your frontal, ethmoid, and maxillary sinuses.
How to Irrigate
Your sinuses are parallel to the ground, not up and down. When irrigating, point your irrigation device toward the back of your head.
