Nasal Irrigation

Definition

Nasal irrigation is the practice of flushing the nasal cavity with a sterile solution. The solution may contain antibiotics or steroid medications.

Purpose

Nasal irrigation is used to clear infected sinuses or may be performed after surgery to the nose region. It may be performed by adding antibiotics to the solution to treat nasal polyps, nasal septal deviation, allergic nasal inflammation, chronic sinus infection, and swollen mucous membranes. One benefit of nasal irrigation in treating these conditions is that it usually lowers the amount of medication that the patient must take by mouth.

Irrigation is also used to treat long-term users of inhalants, such as illicit drugs (cocaine ), or such occupational toxins as paint fumes, sawdust, pesticides, and coal dust.

Nasal irrigation may also be used in occupational medicine to monitor workers for exposure to airborne glass fibers, asbestos, and similar materials.

Precautions

Nasal irrigation should not be performed on people who have frequent nosebleeds; have recently had nasal surgery; or whose gag reflex is impaired, as fluid may enter the windpipe.

Description

Nasal irrigation can be performed by the patient at home or by a medical professional. A forced-flow instrument, such as a syringe, is filled with a warm saline solution. The solution can be commercially prepared (Ayr, NaSal) or can be prepared by the patient, using one half teaspoon salt with each eight ounces of warm water. Occasionally, antibiotics or steroids are added to the solution to kill bacteria and aid healing of irritated membrane. The syringe is then directed into the nostril. The irrigation solution loosens encrusted material in the nasal passage, and drainage takes place through the nose. The patient leans over a catch basin during irrigation, into which the debris flows. Irrigation continues until all debris is cleared from the passage. Nasal irrigation can be performed up to twice daily, unless the irrigation irritates the mucous membrane.

Preparation

Before nasal irrigation, the patient is instructed not to open his or her mouth or swallow during the procedure. Opening the mouth or swallowing may cause infectious material to move from the nasal passage into the sinuses or the ear.

Risks

Complications of nasal irrigation include irritation of the nasal passages due to extreme temperature of the irrigation solution. Rarely, irrigation fluid may enter the windpipe in people with a poor gag reflex.

Resources

BOOKS

Beers, Mark H., MD, and Robert Berkow, MD., editors. "Hypersensitivity Reactions." Section 12, Chapter 148 In The Merck Manual of Diagnosis and Therapy. Whitehouse Station, NJ: Merck Research Laboratories, 2004.

PERIODICALS

Aukema, A. A., and W. J. Fokkens. "Chronic Rhinosinusitis: Management for Optimal Outcomes." Treatments in Respiratory Medicine 3 (February 2004): 97-105.

Brown, C. L., and S. M. Graham. "Nasal Irrigations: Good or Bad?" Current Opinion in Otolaryngology and Head and Neck Surgery 12 (February 2004): 9-13.

Lavigne, F., M. K. Tulic, J. Gagnon, and Q. Hamid. "Selective Irrigation of the Sinuses in the Management of Chronic Rhinosinusitis Refractory to Medical Therapy: A Promising Start." Journal of Otolaryngology 33 (February 2004): 10-16.

Paananen, H., M. Holopainen, P. Kalliokoski, et al. "Evaluation of Exposure to Man-Made Vitreous Fibers by Nasal Lavage." Journal of Occupational and Environmental Hygiene 1 (February 2004): 82-87.

ORGANIZATIONS

American Academy of Family Physicians (AAFP). 11400 Tomahawk Creek Parkway, Leawood, KS 66211-2672. (800) 274-2237 or (913) 906-6000. 〈http://www.aafp.org〉.

American Academy of Otolaryngology, Head and Neck Surgery, Inc. One Prince St., Alexandria, VA 22314-3357. (703) 836-44 44. 〈http://www.entnet.org〉.

KEY TERMS

Irrigation— In medicine, the practice of washing out or flushing a wound or body opening with a stream of water or another liquid.

Saline— A solution made from salt and water.