- Antral lavage, antral washout, bulb syringe, endonasal mucosa care, hyperthermia, hypertonic Dead Sea salt, hypertonic saline, inhaler humidified warm air, intranasal douche, Jala Neti, jet lavage, nasal douche, nasal hyperthermia, nasal lavage, nasal saline solution lavage, nasal sprayer, nasal washing, nebulization, neti (irrigation) pot, power irrigation, respiratory hydrotherapy, RhinomerÂ®, saline lavage, saline nasal irrigation, Smiegelof’s irrigation, steam inhalation.
- Not included in this review: Proetz displacement (saline irrigation combined with suctioning).
- Yoga enthusiasts have used nasal irrigation for thousands of years to clear the sinuses and the mind. Today, nasal irrigation is becoming more widely accepted as a home remedy for allergies, colds, and sinus infections. Nasal irrigation can be performed up to twice daily at home or in a doctor’s office, as long as it does not irritate the mucous membranes.
- Saline lavage is a type of nasal irrigation that uses a warm liquid solution. Humidified warm air lavage (hyperthermia) uses heated mist, steam, or humidified air. Large-particle nebulized aerosol therapy uses a saline solution nasal spray. Occasionally, antibiotics are added to the solution.
- There is variability in nasal irrigation techniques. Differences include the method of saline delivery, the strength of the saline solution, and the use of other additives. Delivery methods include the traditional neti (irrigation) pot, nasal sprayer, bulb syringe, cupped hand, and commercially available devices. The strength of the saline solution depends on the amount of salt added to the water. Additives have included antibiotics, substances that narrow the blood vessels (called vasoconstrictors), and buffers, which reduce acidity. Some practitioners recommend buffered hypersaline solution, although this may irritate the nasal tissues. Gravity-fed normal saline is often used in Jali Neti, one form of nasal irrigation.
- There is growing evidence to support nasal irrigation because it is more natural, soothing, generally safe, and less expensive than many over-the-counter medications. It also does not cause side effects often associated with these medications, such as drowsiness and nausea.
- The International Consensus Report on the Diagnosis and Treatment of Rhinitis recommends nasal irrigation for the treatment of swollen nasal airways (called rhinitis). There is good evidence for the use of nasal irrigation in allergic rhinitis and sinusitis. There is also promising early evidence that nasal irrigation may help treat the common cold, respiratory symptoms from occupational exposure, and wounds after sinus or nasal surgeries. Nasal saline irrigation is still the main treatment for acute rhinitis in infants because excessive use of nasal drops that narrow blood vessels is unsafe in early childhood.
These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.
Several studies suggest that nasal irrigation with normal or hypertonic saline may effectively treat allergic rhinitis in adults and children. Better studies are needed before a strong recommendation can be made.
Early research suggests that nasal irrigation may help treat chronic sinusitis, with improvements in sinus-related quality of life, decreases in symptoms, and decreases in medication use. Further study is needed before a strong recommendation can be made.
Early research suggests that hypertonic saline aerosol may enhance the clearance of lung secretions. More studies are needed.
Early human studies found that nasal steam inhalation may not improve common cold symptoms. Well-conducted research is needed to make a more compelling case.
There is some evidence that saline nasal irrigation or inhaled steam may improve mucus clearance in people with cystic fibrosis. Some studies have added antibiotics or drugs that affect cellular sodium channels. Further study is needed.
Studies have examined whether the amount of bacteria in the nasal passages before and after nasal surgery can be reduced by nasal washing (with or without added antibiotics or corticosteroids). Although some evidence suggests that bacteria are reduced, it is unclear if this therapy reduces the risk of infections after surgery.
Early evidence supports the use of nasal irrigation for respiratory symptoms or diseases caused by occupational exposure to dust or air pollutants. In addition, several studies suggest that nasal irrigation may be used to examine the inhalation effects of acute occupational exposure, especially to pollutants. More research is needed in this area.
*Key to grades:
The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.
Many complementary techniques are practiced by healthcare professionals with formal training, in accordance with the standards of national organizations. However, this is not universally the case, and adverse effects are possible. Due to limited research, in some cases only limited safety information is available.
- This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration ().
- Berger ME, Jones OW, Ricks RC, et al. Decontaminating the nasal passages. Health Phys 2003;84(5 Suppl):S80-S82.
- Cordray S, Harjo JB, Miner L. Comparison of intranasal hypertonic dead sea saline spray and intranasal aqueous triamcinolone spray in seasonal allergic rhinitis. Ear Nose Throat J 2005;84(7):426-30.
- Desrosiers MY, Salas-Prato M. Treatment of chronic rhinosinusitis refractory to other treatments with topical antibiotic therapy delivered by means of a large-particle nebulizer: results of a controlled trial. Otolaryngol Head Neck Surg 2001;125(3):265-269.
- Friedman M, Vidyasagar R, Joseph N. A randomized, prospective, double-blind study on the efficacy of dead sea salt nasal irrigations. Laryngoscope 2006;116(6):878-82.
- Garavello W, Di Berardino F, Romagnoli M, et al. Nasal rinsing with hypertonic solution: an adjunctive treatment for pediatric seasonal allergic rhinoconjunctivitis. Int Arch Allergy Immunol 2005;137(4):310-314.
- Garavello W, Romagnoli M, Sordo L, et al. Hypersaline nasal irrigation in children with symptomatic seasonal allergic rhinitis: a randomized study. Pediatr Allergy Immunol 2003;14(2):140-143.
- Greiff L, Anderson M, Wollmer P, et al. Hypertonic saline increases secretory and exudative responsiveness of human nasal airway in vivo. Eur Respir J 2003;Feb, 21:308-312.
- Heatley DG, McConnell KE, Kille TL, et al. Nasal irrigation for the alleviation of sinonasal symptoms. Otolaryngol Head Neck Surg 2001;125(1):44-48.
- Passali D, Damiani V, Passali FM, et al. Atomized nasal douche vs nasal lavage in acute viral rhinitis. Arch Otolaryngol Head Neck Surg 2005;131(9):788-790.
- Rabago G, Manito N, Palomo J, et al. Improvement of chronic renal failure after introduction of mycophenolate mofetil and reduction of cyclosporine dose. J Heart Lung Transplant 2001;20(2):193.
- Rabago D, Zgierska A, Mundt M, et al. Efficacy of daily hypertonic saline nasal irrigation among patients with sinusitis: a randomized controlled trial. J Fam Pract 2002;Dec, 51(12):1049-1055.
- Ricchetti A, Landis BN, Maffioli A, et al. Effect of anti-fungal nasal lavage with amphotericin B on nasal polyposis. J Laryngol Otol 2002;116(4):261-263.
- Shin SH, Ye MK. Effects of topical amphotericin B on expression of cytokines in nasal polyps. Acta Otolaryngol 2004;124(10):1174-1177.
- Tano L, Tano K. A daily nasal spray with saline prevents symptoms of rhinitis. Acta Otolaryngol 2004;124(9):1059-1062.
- Wormald PJ, Cain T, Oates L, et al. A comparative study of three methods of nasal irrigation. Laryngoscope 2004;114(12):2224-2227.
Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to . Selected references are listed below.