Saline nasal douches as a treatment for chronic rhinosinusitis
(Long term inflammation of the sinuses)
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Peter John Wormald MD, FRACS, FCS(SA), FRCS, MBChB Professor and Chairman, Department of Otorhinolaryngology University of Adelaide, Adelaide, Australia About the author: Professor Peter-John Wormald, MD is one of the world’s foremost sinus surgeons and a recognized world leader in sinus related technology. He has been Chair of the Otolaryngology head and Neck Surgery since 1998. |
Chronic rhinosinusitis (CRS) is a disease characterized by inflammation of the lining of the sinuses with resultant sinus ostia obstruction. This sinus ostial obstruction leads to retention of secretions within the sinuses with secondarily colonization by bacteria further adding to the inflammation. Characteristically these patients present with greater than 3 month symptoms of nasal obstruction, rhinorrhea, post nasal drip, facial pain or pressure and loss of the sense of smell. In the first instance treatment is medical with systemic and topical steroids given in an attempt to reduce the inflammation and consequent edema with opening of the natural sinus ostia. Saline nasal washes are then given in an attempt to wash out the sinuses through these newly opened ostia. For this treatment to be successful, the saline needs to penetrate the sinus ostia and get into the sinuses and wash out the retained secretions. Nasal sprays and nebulizers do not produce enough volume or pressure to penetrate these small sinus ostia and therefore douching with a plastic squeeze bottle with a volume of 240mls of saline provides the most effective treatment.
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In a normal human nose paranasal sinus outflow paths are so small that even the breathing air does not enter the sinuses like it does not enter the middle ear through the Eustachian tube. In most cases iririgation fluid does not enter the sinuses. The effect of irrigation happens mostly within the nose where it makes thick mucus more fluent so that active cilia movement can transport it better. If maxillary sinusitis have caused maxillary sinus perforation (s.c. accessory ostium) or sinus surgeon has opened narrow outflow channel and enlargened maxillary ostium then irrigation saline may enter the sinus.
Ever since I started using the squeze bottle (havn’t tried the neitipot) I have had relief from my congestions and my stuffed nose. I have had problems due to allergies since 1952 and was given pills to take. All that did was give me temporary relief. After getting married in Oct 2005 (2nd) I moved to Central Pennsylvania which meant new doctors. I am ever so thankful that I found Dr. Bruce my new ear nose and throat doctor..he is the one who recommended I use the NeilMed Product. Best advice I have ever had. For the first time in 61 years I am in comfort. Thank You for NeilMed.
I used a neti pot one time because I was trying to avoid, or maybe clear a sinus infection. I’m convinced it made it worse. I haven’t used one since. If someone out there can convince me to try again, I’m all ears. Maybe I started using it too late; I don’t know.
My family, like many others, has a history of allergies and related sinus issues that have caused recurrent sinus to migraine headaches and infections over the years. In my case, I had become accustomed to knowing I would probably wake up daily developing some sort of headache from mild to severe due to the sinus pressure from congestion. I enjoy singing with a choir, but because of the congestion, it usually interfered with being able to sing effectively. Some of the members suggested that the nasal wash system had helped them.
After years of battling these headaches, congestion and infections, I decided to try using the NeilMed system, using the pulsating Sinugator. Though I was a little skeptical of the results I would achieve, I have been pleasantly rewarded for my efforts. I also began working with an ENT doctor who had me combine a liquid steroid solution mixed in with the saline doing the washes twice a day for a few months.
As a result, my headaches have decreased significantly and I have had no infections occur, plus I am breathing easier. The idea of washing out my sinuses sounded gross and caused me to resist trying this for many years but now I wish I had tried it earlier. With the Sinugator, it goes so fast, it is done in a minute or two and helps clear out any congestion.
Great product!
I’ve been using neil med and the following technique for years. I added 2 steroidal squirts each nostril followed by 2 astepro squirt into each nostril. It is even more critical to drain the cavities by tilting the head downward and softly blowing after each rinse and then again when using each of the sprays. Surgery did not eliminate the problem but did make the rinses and sprays work much easier. wait a minute after the the rinses and sprays before expelling the liquids and do this with the head tilted downward. NOTE all squirts should be done with the head tilted forward.
It sounds messy but it sure does the job for me. I also expel the liquid while my head is really almost upside down while blowing gently into a paper towel.
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I have been treating CRS since 2008, including months-long antibiotic regimens and sinus surgery. Neilmed sinus irrigation is my number one treatment and maintenance option since surgery, including twice a day irrigations or more if I am fighting an active infection. I highly recommend this for anyone with CRS or allergies.rrrchitt
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