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Nasal Disease Handbook

Anatomy & Physiology

Bloody Noses

Common Cold

Cystic Fibrosis

Endoscopic Sinus Surgery

Environmental Control for Allergy

HIV

Nasal Irrigation

Nasal Steroids

Nasal Surgery

Nasal Tip Infection

Rhinitis - Allergic

Rhinitis - Cold-Induced

Rhinitis - Irritative

Rhinitis - Vasomotor

Rhinoplasty

Sinusitis

Sinusitis - Chronic

The Aging Nose

The Crusty Nose

Tobramycin

Tonsillitis with Halitosis

NASAL IRRIGATION 

There are two commercially available nasal irrigation systems.  The first is produced by Hydromed and is called the Grossan Hydro Pulse Nasal/Sinus Irrigation System. Ethicare also makes a nasal irrigation system.  Ethicare makes nasal irrigators which attach to a Teledyne Water Pik.  Both irrigation systems are equally effective.  As the Grossan and the Ethicare systems are designed exclusively for nasal irrigation, it may be easier to obtain medical insurance reimbursement.  Which system you use is a matter of personal preference.  Grossan and Kenwood both provide premade additives.  I have found that commercially available table salt is effective and less expensive.  Some patients, however, have preferred the pre-mixed solutions. 

The following instructions are the same for any of the nasal irrigation systems. 

Assemble the nasal irrigator as instructed in the materials. Turn the water control to the lowest setting. Select and attach the nasal irrigator. The nose is best washed with diluted salt water. No salt or too much salt will cause irritation or a burning sensation. Most people use 1or 2 level teaspoons of common table salt in 500 milliliters (1 pint) of water. Tap water is generally sterile and is excellent for nasal irrigation. The water temperature is controversial. Some like cold water and some like it hot. 98.6^o Fahrenheit, (37^o centigrade) is the body temperature ideal for nasal irrigation. The coolest water that should be irrigated through the nose is 72^o Fahrenheit and the warmest 102^o Fahrenheit. Ten percent of patients say the standard salt solution causes burning.  For these individuals, one quarter to one half teaspoon of baking soda changes the acidity (pH) and will ameliorate the burning problems. A slightly acidic solution is preferred so baking soda should only be used if necessary for comfort.

If you select the Grossan or the Ethicare Nasal Irrigation systems, they come with a nasal adaptor.  If you select the Teledyne Water Pik irrigation system, you will require an adjustable model (these come in drug stores).  You will need to obtain a special nasal adaptor.  Adaptors are available from two sources. 

1. The first is Hydromed which provides the Grossan Nasal irrigator, telephone number (800) 560-9007.
2. The second is the Ethicare Nasal Irrigator, telephone number (800) 253-3599.

Some of these companies produce their own water delivery system. The pusaltile irrigation is the key to success. Non pulsatile systems are not recommended and are considered less effective.

Fill your nasal irrigator with the chosen water temperature and salt concentration. Turn the unit on and lean over the sink. Place the irrigator up to your nose. Let the water run into your nose. It will run out the opposite side or out your mouth. Tilt and twist the irrigator side to side and up and down directing the water flow into all portions of the nasal cavity. When the first nostril feels clean, switch to the opposite side. You can irrigate with one quarter of the bowl, one half of the bowl or the entire bowl. Continue to irrigate until your nose feels clean. This can be repeated once, twice or even 3 times during the day. As you get accustomed to the water cleaning your nose, you can increase the water pressure.