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General Articles on Pulsatile
Nasal Irrigation & Sinusitis
Pulsatile Nasal Irrigation
in Children
Rhinitis
Allergy
Asthma
Post-Operative Care
Cystic Fibrosis
More Laboratory-Oriented Topics:
Ciliary Function & Mucociliary
Clearance (Documentation of Improved Function of the Cilia)
Irrigation Fluid & Salinity
Pulsatile Action
General Articles on Pulsatile
Nasal Irrigation & Sinusitis
Radiographic
Comparison of
Three Methods for Nasal Saline Irrigation, Laryngoscope 112: 1394-1398, August
2002, David E. Olson, M.D., Barry R. Rasgon, M.D., Raymond L. Hilsinger, Jr.
M.D.
"Positive Pressure Irrigation (Sinus Irrigator) irrigates the sinuses more consistently and
reliably than other methods. Of the three methods studied positive pressure
irrigation distributed solution reliably to the ethmoid and maxillary sinuses
and to the bilateral maxillary sinuses in the majority of subjects studied.
Negative pressure irrigation (spray bottles and lavage bottles) Negative
pressure irrigation is the simplest least expensive irrigation method and is
maintenance free, However, delivery with this method is difficult to control and
has the disadvantage of preferentially irrigating the side of the nasal cavity.
It tends to irrigate one maxillary sinus or the other but not both. Distributes
saline solution reliably to the ethmoid and maxillary sinuses.Rinoflow nebulizer:
The system uses technology previously applied to oral nebulizing devices for
delivery of drugs to the bronchopulmonary system. It is comfortable and
easy to use but is expensive ($159), time intensive requiring nearly 10 minutes
per treatment. Of the three treatment methods, the nebulizer gave the
poorest results. Saline distribution was the lowest and the nebulizer
method did not distribute the solution reliably."
Sinusitis: Acute, Chronic and Manageable,
Rachelevsky G S, Slavin R G et all. Patient Care. Feb 28, 1997 Vol 131:4.
"A particularly helpful strategy is saline washing using the Sinus Irrigator is so effective in clearing
the blocked passages that , if it is done regularly, some patients with persistent
or chronic sinusitis need no drug treatment at all.
Sinusitis: Bench to Bedside, Kaliner MA
et al. Otolaryngology June 97 116:6 Part 2 Study of Sinusitis.
Pulsatile sinus irrigation is recommended
as a treatment for sinusitis, and as a supplement to other treatment modalities.
Treatment of Sinusitis in the Next Millennium,
Kaliner, M. Allergy and Asthma Proceedings, 19:181-4, 1998
Saline irrigation with the Sinus Irrigator
is an effective non-drug treatment for sinusitis
Sinus Survival, Ivker R., Putman Publication
1995.
Pulsating irrigation is shown to remove pus and
allow for natural, holistic healing.
Pulsation Irrigation: a Simple, Safe Effective
Treatment of Many Nasal Complaints, Pope, A., O.R.L. Digest August 1974
15:8 pp 3638.
Pulsatile nasal irrigation is recommended as
a simple safe treatment for many sinus, ear and allergy complaints. High
patient acceptance and enthusiasm is reported.
Pulsatile Nasal Irrigation
in Children
Pediatric sinusitis, Manning, Scott, C., In:
Inflammatory Diseases of the Sinuses. Otolaryngologic Clinics of North
America. Volume 26, Number 4, pp 623-638 (1993).
Pulsatile irrigation works for children, even
without antibiotics.
Rhinitis
Atrophic Rhinitis, Goodman, Wilfred S.
English: Otolaryngology Vol 2 Ch. 14 1984
Atrophic rhinitis varies in severity and is difficult
to cure. Dr Goodman recommends Pulsatile irrigation for symptomatic relief
and treatment.
Medical Management of Rhinitis, Fadal R.
English: Otolaryngology Vol 2:Ch 13
The principal benefits from saline irrigation
include: 1. Augments mucociliary flow 2 Liquefies tenacious mucus 3. Soothes
irritated tissues 4. Removes crusts and microforeign bodies 5. Augments
tissue repair 6. Reduces forceful nose blowing 7. Improves olfaction.
Chronic Rhinitis, a Practical Approach to Diagnosis
And Treatment, Zeigler, R. Shatz , M Part 2 Treatment. Immunology,
Allergy Practice 1982. 4:3 pp 26-36
Good allergy management includes use of irrigation
for removal of offending particles and restoring normal ciliary flow.
Rhinitis, Allergy: Principles and Practice,
3rd edition. Middleton E. CV Mosby Company Ch 17, 1988
All forms of allergy rhinitis are benefited by saline irrigation with the Sinus Irrigator.
Medical Management of Rhinitis, Fadal R.
English: Otolaryngology 1996, Vol 2:Ch 13.
The principal benefits from saline irrigation
are shown to include: 1. Augments mucociliary flow 2 Liquefies tenacious
mucus 3. Soothes irritated tissues 4. Removes crusts and micro foreign bodies
5. Augments tissue repair 6. Reduces forceful nose blowing 7. Improves olfaction.
Atrophic Rhinitis, Goodman, Wilfred S.,
Otolaryngology Vol 2 Ch. 14 1984.
Atrophic rhinitis varies in severity and is difficult
to cure. Pulsatile irrigation is recommended for symptomatic relief and
treatment.
Chronic Rhinitis, a Practical Approach to Diagnosis
and Treatment, Zeigler, R. Shatz , M Part 2 Treatment. Immunology,
Allergy Practice 1982. 4:3 pp 26-36.
Good allergy management is shown to include irrigation
for removal of offending particles in order to restore normal ciliary flow.
Atrophic Rhinitis, deSouza F.M.: Chapter
14N, English: Otolaryngology 1996.
"The Sinus Irrigator has increased the efficiency of saline
nasal douches."
Asthma
Sinusitis and Bronchial Asthma, Slavin RG:
J Allergy and Clinical Immunol 66:250-257, 1980
Slavin presents three mechanisms re sinusitis
causing asthma. Clearing sinusitis is important in asthma.
Allergy
Inhibition Of The Seasonal Ige Encrease To Dactylis
Glomerata By Daily Saline Nasal - Sinus Irrigation During The Grass Pollen
Season, Journal of Allergy and Clinical Immunology. In press
Pulsatile irrigation works for allergy by removing
the IgE so that the pollen doesn't cause symptoms.
Post-Operative Care
Perioperative Care in Functional Endoscopic Sinus
Surgery, Sonkens JW, Miller R.J. Highlilghts of the Instructional Course.
Ed Lucente, editor Chapter 24. pp267-277
Pulsatile irrigation should be done 1 to 3 times
a day postoperatively until no further benefit is achieved.
Endoscopic Paranasal Sinus Surgery,
Rice,
D., Ravens Press 1993.
Pulsatile irrigation before sinus surgery is recommended to reduce infection and after surgery to restore ciliary function
and reduce patient's symptoms.
Cystic Fibrosis
Management Of Sinusitis In Cystic Fibrosis,
Moss RB, King W. . Arch Otolaryngol Head Neck Surg. 1995;1 21:566-572.
Stresses the use of irrigator with nasal adaptor for home use. Recommends antibiotic irrigation of sinuses.
Management of Chronic Sinusitis in Cystic Fibrosis,
Davidson, T., Laryngoscope 105:354 April 1995.
Cystic fibrosis is commonly associated with sinusitis
due to mucociliary system failure. Patients may benefit by lung transplant.
Pre-op pulsatile saline irrigation is found to be a successful means of
clearing the sinus of disease.
More Laboratory-Oriented Topics
Ciliary Function & Mucociliary
Clearance
Mucociliary Clearance and Buffered Hypertonic
Saline Solution, Talbot A, et al Laryngoscope 107:April 1997
Stresses the importance of saline irrigation
for Mucociliary Clearance for patients with acute and chronic sinusitis,
and post operative functional endoscopic sinus surgery. Finds close correlation
with the saccharin test to other methods of measurement.
Sinusitis: Complications And Sequelae: An Otolaryngologist's
Perspective, Fairbanks, D.N.F.: Pediatr Infect Dis J 4 (Suppl 6) 875-878
1995
Shows that radiographic material placed in the
nose before bedtime is found in the tracheobronchial tree in the morning.
Thus sinus secretions can contaminate the tracheobronchial tree causing
infection and bronchospasm. Hence the value of irrigation to remove offending
material.
Ciliary Beating Frequency in Chronic Sinusitis,
Nuutinen J, Arch Otolaryngol Head Neck Surg 119:645, 1993.
After diseased mucosa is cleared of thick mucus
and bacteria, ciliary function is shown to return.
Irrigation Fluid & Salinity
Physiologic and Hypertonic Saline Solutions Impair
Ciliary Activity in Vitro, Boeck,Wilbert. Keles, Nesil. Graamans, Kees,
Laryngoscope March 99 No 3, p.396.
Certain hypertonic saline solutions cause ciliostasis
(the cilia stop functioning) from which the cilia may not recover. If cilia
are permanently damaged, the ability to fight infection is lost.
Pulsatile Action
Using Pulsatile Pressure Saline/Antibiotic Irrigation,
Betts N. et al. Compendium Contin Educa Dent, 17(9): 871 1996.
The efficacy of pulsatile saline irrigation has
been demonstrated in orthopedics, surgery and dental literature too.
Evaluation Of Wound Irrigation By Pulsatile
Jet And Conventional Methods, Brown LL; Shelton HT. Ann Surg. 1978
Feb, 187:2, 170-3
Comparison with pulsatile irrigation versus bulb
syringe - only pulsatile irrigation about significant reduction of bacteria.
Conclusion: pulsatile irrigation removed bacteria from experimental wounds
more efficiently than conventional procedures.
The Efficacy of Various Irrigation Solutions
in Removing Slime Producing Staphylococcus, Anglen, J. J., Orthop Trauma 1994 Oct;8(5):390-6.
In an orthopedic research project, it is shown
that pulsatile irrigation is 100x more effective in removing bacteria from
a site than simple irrigation, and is even more effective than some antibiotic
solutions in tests for clearing infection.
Sinus Irrigation products from Health Solutions
Medical Products Corporation
may be ordered through your independent pharmacist and at select drug stores.
If your pharmacy does not stock the item please ask your pharmacist to
special order through their wholesaler or they may contact us toll free
at: Health Solutions at (800) 305-4095.
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