Nasal Irrigation

Tips For Proper Nasal Irrigation

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  • NeilMed Sinus Rinse for daily nasal irrigation.
  • Many patients prefer to use Ringer Lactate solution instead, as they find it’s easier on the mucosa than regular saline, and there are some empirical studies that back up that claim.
  • Hyaluronic Acid Base spray, like HylaMist.
  • Grossan Hydro Pulse Irrigator.  Irrigate at least a half hour before bedtime in order to drain the water from your sinuses before sleep. Tilt your head around on each side to drain excess water so that you don’t leak water when you lean over later.
  • New tip on how to get the most out of pulsatile irrigation recommended Dr. Tichenor. This method might be particularly beneficial for cleaning the nose of an ENS sufferer who has thick, viscous mucus as well as sinusitis and postnasal drip sufferers. This method consists of tilting your head to the side, so that your head is parallel to the ground. Make the sure the stream of the irrigation is only 1” high and the pressure is low. Then irrigate into the lower nostril for about 4 to 5 seconds or 15-20 cc’s, lift your head up and let the water drain out of your sinuses. If you find water gets into your ears, then lower the pressure or perform the irrigation for fewer seconds. After you are done irrigating 3 or 4 times on the one nostril, proceed to irrigate the other side.
  • Irrigation with antibiotics (Guaifenesin)
  • Strategies to further thin mucus, thereby bolstering effectiveness of irrigation: steam inhalation and taking warm showers before and/or after irrigation.  Adding about 5 drops of eucalyptus oil to water after steaming it in order to provides the analgesic (pain-relieving) and antibacterial properties of eucalyptus oil.
  • Another option is to take a shower immediately before or after an irrigation. Have warm water pour down on your sinuses and you might actually feel the drainage occur. The heat and moisture from the water will certainly help to thin mucus.
  • Saline Rinse 2-3 times daily. Inverted in the tub works best. I haven’t noticed any difference with different recipes so I just use plain salt and tap water. Lying flat on my back for about 5-10 minutes afterwards helps the excess water drain out.
  • Directions for Hydro Pulse Irrigation with Additives. Add one teaspoon of salt to Hydro Pulse Basin. Add warm water to 500 cc and mix.  Set the pressure at the nasal tip so that the stream is about one inch high.  Irrigate the nose 300 cc (about 150 cc each side) to clear the mucus.  Stop and gently clear the nose.  Add medication to the remaining 200 cc.  Irrigate about 100 cc each side till empty.  Sit quietly for 10 minutes at the sink. No blowing.  Do not blow the nose for 2 hours.  Some physicians will add 40 mg of Gentamycin to the 200 cc. Others use Tobramycin esp for patients with cystic fibrosis. Some physicians will add 1/2 of a tube of Bactroban to the 200cc (this is hard to dissolve, but it will – keep mixing!). Some physicians are using antifungals, as some research has shown a possible link for chronic rhinosinusitis and fungi.

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