Benefit of saline irrigation in sinusitis and allergic rhinitis
|Devin M. Cunning, MD, FACS
Diplomat American Board of Otolaryngology
Diplomat ABOto, Sleep Medicine
Fellow American Academy of Otolaryngic Allergy
Nasal saline irrigation are integral to the treatment of chronic sinusitis and are a helpful adjuvant in treating allergic rhinitis.
Most problems with the sino-nasal cavities generally begin with inflammation. With inflammation, either from an infectious etiology or an allergen, comes obstruction. Obstruction can be realized symptomatically as a multitude of differing but related complaints. Firstly nasal congestion or difficulty breathing through the nose is common. Sinus pressure may also manifest as facial pain, pressure or upper dental pain. Additionally Eustachian tube dysfunction or plugging of the ears may ensue.
During this process of inflammation due to sinus infection, the mucus secretions become thick and tenacious, resulting in the further obstruction of the sinus cavities. Guaifenesin is helpful in turning, as I say ‘rubber cement into water.’ It reduces the viscosity of sinus mucus secretions allowing egress from the sinus cavities. The combination of guaifenesin and saline irrigations function additively in cleansing the sinus’s, removing infectious agents and reestablishing normal ciliary (nasal hair cell) function while directed antibiotics kill the bacteria.
Allergic rhinitis is caused by the body’s immune response to foreign proteins or allergens. This also results in inflammation, however often the sinus secretions are thin and watery. Aside from immunotherapy which results in long term diminished allergies, my trifecta for treating this condition includes nasal steroid spray which topically reduces inflammation, antihistamine which systemically reduces the effects of histamine, including itching and watery discharge, and saline irrigations which help flush the allergens from the sino-nasal cavities. Remember: “The solution to pollution is dilution.”