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Several products on the market
utilize hypertonic saline to spray or irrigate the nose and others isotonic. What
exactly is
hypertonic and isotonic? Which is better for me?
Isotonic saline solution - "Iso" refers to something equal and in this
case it means that the concentration of salt or saline is equal to or
similar to salt concentration of body fluids.
Hypertonic saline solution - "Hyper" refers to something "greater" or
"higher" and in this case it means that the solution has a greater salt content
than body fluids. A hypertonic solution is thought to be better at reducing
swelling of the mucous membranes because of this greater salt concentration.
Locke-Ringer, Gleichenberger, and Ems salt solutions - Well known
solutions with varying concentrations of different salts.
There has been some research
on the best solution to use. but it is mostly conflicting. Although some
research shows that hypertonic solutions are more effective than isotonic
solutions, other studies show that hypertonic solutions decrease sinus drainage
and movement of the cilia, which are cells that "sweep" the sinuses and push
particles out. From the few research studies conducted on Locke-Ringer,
Gleichenberger, and Ems salt solutions , these do not appear to decrease ciliary
movement, making them preferable to hypertonic saline solutions.
Our SinuAir® powdered saline mix
is a modified Ringer’s solution. Several medical articles
have demonstrated this solution best for restoring nasal ciliary function. SinuAir®
preservative free and contains no Benzalkonium, known to impair cilia
function, cause burning or stinging sensation, and cause rebound and congestion.
There are several economical
advantages with our concentrated formulated saline. It is much less expensive than the leading
hypertonic solutions. When mixed yourself SinuAir® used as a spray, from our standard
200 gm bottle will make over 40 pints or 640 ounces of an Isotonic solution. 20 pints or
320 ounces of a 2x hypertonic solution.
Compare this
to the size and price of the other leading hypertonic solutions.
The advantage of SinuAir™
powdered saline is the ability to customize your saline concentration (Isotonic
or Hypertonic) to your individual comfort. The ability to change concentration
and not purchase a new product provides flexibility and economy. If your nose is dry
and irritated, a hypertonic solution can make the nose drier by taking liquid out.
In this particular instance an isotonic solution is
better. However, if your nose is swollen, a hypertonic solution may be best. It
is recommended to start with isotonic and move slowly to hypertonic. Over time a hypertonic
solution may be too
strong for some and should be reduced to an isotonic concentration. There
really is no universal answer.
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For a 2X
hypertonic
solution, just add the 1 teaspoon to 8 ounces of water or 2 teaspoons to 16
ounces
for use with the SinuPulse Elite®.
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For a 3X hypertonic,
just add 1 1/2 teaspoons to 8 ounces of water or 3 teaspoons to 16 oz of water
for use with the SinuPulse Elite®.
What about plain water?
Salt follows
water, and water follows salt. Anyone who has ever seen the effect of salt on a
snail knows what happens to the snail. Hypertonic saline will tend to draw a
small amount of water from the tissues it contacts; this is desirable if the
tissues are swollen. Plain water, on the other hand, will tend to enter the
tissues, thereby increasing swelling. When you sit for a long time in a
bath, your fingertips wrinkle because the water content of the skin is
increasing, so the skin must "buckle" to accommodate the extra water. In
addition irrigating with plain water can irritate or be uncomfortable.
Each
SinuAir® package contains:
200gm of formulated saline
powder for nasal solution
Refillable nasal spray bottle
Double sided
measuring spoon
For more
information on obtaining SinuAir®,
click here.
References:
Physiologic
and hypertonic saline solutions impair ciliary activity in vitro. Boek WM.
Laryngoscope, 109(3):396-9 1999 Mar
Physiological salt solution (0.9%) was found to slow cilia
movement. Locke-Ringers solution with soda bicarbonate, potassium and calcium
chloride, and salt was found best for cilia. "This solution is more
appropriate than saline for nasal irrigator and nebulazation or sinus lavage."
He reported complete ciliastasis with some hypertonic solutions, often within 5
minutes of exposure.
Benzalkonium
chloride in a decongestant nasal spray aggravates rhinitis medicamentosa in
healthy volunteers. Clin Exp Allergy.1995; 25:957-965
Benzalkonium chloride induces mucosal swelling, which
explains why the presence of this preservative in a decongestant spray
aggravates nasal/sinus symptoms
Effects
of topical nasal steroids on human respiratory mucosa and human granulocytes in
vitro. Steinsv¡ag S. Acta Otolaryngol (Stockh), 116(6):868-75 1996
"It is concluded that benzalkonium chloride has toxic
effects on human respiratory mucosa and human neutrophils in vitro."
Effect
of topical corticosteroids and topical antihistaminics on ciliary epithelium of
human nasal mucosa in vitro. Hofmann T. HNO, 46(2):146-51 1998 Feb
"An irreversible cessation of ciliary movement was
observed in all cells exposed to nasal sprays containing benzalconium
chloride....." "we recommend that this preservative should not be used
anymore in topical nasal medications."
The
effects of topical nasal steroids on rat respiratory mucosa in vivo, with
special reference to benzalkonium chloride. Berg OH. Allergy, 52(6):627-32 1997
Jun
"In conclusion, benzalkonium chloride appears to be
potentially toxic to the nasal mucosa."
A
clinical trial of hypertonic saline nasal spray in subjects with the common cold
or rhinosinusitis. Adam P. Arch Fam Med, 7(1):39-43 1998 Jan-Feb
Hypertonic saline does not improve nasal symptoms or
illness duration in patients with the common cold or rhinosinusitis. Thirty two
percent of users noted burning and wouldn't use the product again.
© Copyright
2004 Health Solutions Medical Products Corp.
Health Solutions Medical Products
Corp.
P.O. Box 4278
Culver City, CA 90231-4278
U.S.A.
Tel 800.305.4095 (Within
the US)
Tel. 310.837.3191 (Outside
the US)
Fax. 310.837.1065
E-mail sales@allergy-sinusrelief.com
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