Mechanism of Action
The precise reasons for the efficacy of nasal irrigation are not well understood, although it is clear that the removal of mucus plays an important role. Damage to the mucociliary transport system is an important factor in the development of sinonasal diseases, leading to a stasis of mucus. The numerous proteins found in nasal mucus include inflammatory mediators, defensins and many whose function is not understood. Thus hypotheses include that nasal irrigation may decrease inflammation through the removal of mucus, that it may improve mucociliary clearance, and that it may remove thickened mucus that cannot be handled by the cilia.
In a study with eight healthy volunteers, solution was transported reliably to ethmoid and maxillary sinuses when it was snorted or applied with a squeeze bottle; a nebulizer was significantly less effective. Sphenoid and frontal sinuses were rarely reached, and not at all with the nebulizer.
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