Nasal Irrigation - Methods

Methods

A simple method, which requires no specialized equipment, is to snort water from cupped hands, but this clears little more than the nostrils. The application of commercially available saline nasal spray is another simple alternative, but it is relatively inefficient for washing away debris although it may suffice for simple rehydration of mucous and tissues.

A simple yet effective technique is to pour salt water solution into one nostril and let it run out through the other while the mouth is kept open to breathe, using gravity as an aid. Jala-neti, which means to cleanse the nose with water, is an old yogic technique. The container used to administer the saline is called a "neti pot". Neti is Sanskrit for "nasal cleansing". A second neti technique known as sutra neti uses a piece of string instead of water.

Neti pots are typically made of metal, glass, ceramic or plastic. They rely on gravity, along with head positioning and repeated practice in order to rinse the outer sinus cavities. Typically it has a spout attached near the bottom, sometimes with a handle on the opposite side. Some users are able to use neti pots without problems, while the sideways positioning of the head can induce vertigo in others. A more advanced variation of the technique (known in yoga as Vyutkrama Kapalaneti) involves pouring the same salt water solution into one nostril while the other is held closed, so that the solution runs out of the mouth. It is more challenging than the basic version (care must be taken to keep the saline solution out of the throat and to suppress possible vomiting reflex), but it can allow more thorough irrigation of the nasal cavity and the sinuses. Yet another technique (known in yoga as Seethkrama Kapalaneti) is to take the saline into the mouth and - leaning forward - force it out of the nostrils. This is not recommended for beginners.

The second method of nasal irrigation is to introduce some form of positive pressure to the water introduced into the sinuses and nasal cavities in order to provide a more complete rinsing without resorting to special techniques, such as holding the head to one side (which is usually only difficult with a neck condition). Some products available from pharmacist supply retailers are essentially bottles made of flexible plastic with special tips to fit the nostril. These bottles, when filled with warm salt water solution, can be squeezed to exert positive pressure of the water flowing through the sinuses while the mouth is kept open at all times in order to breathe and prevent snorting the liquid down the throat. Even ordinary plastic water bottles can and have been used, as long as the nozzle will adequately fit a person's nostril. However, neither squeeze bottles nor bulb syringes provide the user with any genuine control over the pressure/volume of solution introduced. You need to make sure the pressure cannot be too high, to prevent ear pressure or ear infection. The diameter of the hole in the center of the nostril fitting cannot be larger than 3 mm. If too large, a big wave of liquid can be forced to enter anywhere, such as middle ear, causing ear pain or even ear infection.

Irrigation machines that utilize electric motor-driven pumps are also available. These irrigation devices pump salt water solution through a tube, in connection with a nasal adapter tip designed to seal against the nostril. Some of these machines allow adjustment of water volume/speed by use of an adjustment dial which regulates pump speed and volume per minute. Most of these motorized machines use a pulsatile or pulsating water pumping action at a relatively low, predetermined fixed pulse cyclic rate, designed to match the normal wave rate of healthy, unobstructed nasal cilia. This matched pulse rate is claimed to stimulate the nasal cilia hairs and promote better sinus health, while reducing the severity of allergic reactions. More sophisticated motorized irrigators have two or more pulse cycle settings that adjust the actual pulse cycle (as opposed to a simple volume/speed control, which does not alter the pulse cyclic rate). This design affords the user the option of using a higher pulse cyclic rate when suffering from partially closed sinuses, as in a typical case of acute sinusitis. The efficacy of all motorized pump irrigators has not yet been tested compared to simpler non-motorized mechanical pressure nasal irrigation methods.

Some nasal irrigation systems that apply pressure have an anti-backwash valve to prevent used saltwater solution from flowing back into the nasal cavity. This is particularly important for those people with bacterial or viral infections, such as the common cold or flu. This type of irrigator should be held upright, as in brushing one's teeth, because if the head is tilted sideways liquid could enter the ear on the lower side and cause an ear infection. This refers to an irrigator that applies pressure, but not to the neti pot, which only utilizes gravity in its application. Neti pots do not allow used solution to flow back into the nasal cavity.