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Nasal irrigations: good or bad?

Brown, Christopher L.; Graham, Scott M.

Current Opinion in Otolaryngology & Head and Neck Surgery: February 2004 - Volume 12 - Issue 1 - p 9-13
Nose and paranasal sinuses

Purpose of review Nasal irrigations are often mentioned as adjunctive measures in treating many sinonasal conditions. Despite their widespread use, much mystique and uncertainty exist about the indications and therapeutic mechanisms of nasal irrigations. Anecdotal evidence and poorly controlled studies add to the confusion. Recent evidence challenges some of the assumptions underlying the use of nasal irrigations.

Recent findings Studies of nasal irrigations continue to report the benefits in managing sinonasal complaints. Apart from improved patient symptomatology, prescription medication use is often decreased. When nasal irrigations are combined with other medical modalities, patients with chronic sinusitis may not require surgical intervention as often. In particular, patients using hypertonic saline nasal irrigations reported better outcomes. Different devices and techniques exist. Positive-pressure and negative-pressure methods are probably more effective than nebulizers. Furthermore, the popular belief that nasal irrigations need to be sterile is in question.

Summary Nasal irrigations should no longer be considered merely adjunctive measures in managing sinonasal conditions. They are effective and underutilized. Some of the persisting unanswered questions will only be answered by further research.

Department of Otolaryngology–Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA

Correspondence to Scott M. Graham, MD, Department of Otolaryngology–Head and Neck Surgery, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, 21201 PFP, Iowa City, Iowa 52242-1093, USA

E-mail: scott-graham@uiowa.edu

© 2004 Lippincott Williams & Wilkins, Inc.