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| {{Short description|Personal hygiene practice for rinsing out nasal passages}} | |||
| {{Citecheck|article|about.com|date=August 2008}} | |||
| {{Use dmy dates|date=October 2020}} | |||
| ] | |||
| {{Infobox medical intervention | |||
| | Name=Nasal irrigation | |||
| | Image=Jalaneti.JPG | |||
| | Caption=Woman flushing her nose with a neti pot | |||
| | ICD10= | |||
| | ICD9={{ICD9proc|22.0}} | |||
| | MeshID=D055556 | |||
| | OPS301= | |||
| | OtherCodes= | |||
| }} | |||
| '''Nasal irrigation''' (also called '''nasal lavage''', '''nasal toilet''', or '''nasal douche''') is a personal ] practice in which the ] is washed to flush out ] and debris from the ] and ], in order to enhance ]. Nasal irrigation can also refer to the use of ] or ]s to moisten the ]s. | |||
| '''Nasal irrigation''' or '''nasal lavage''' is the personal ] practice in which the ] is washed to flush out excess ] and debris while moistening the ]s of the ] and ]. It has been practised in India for centuries as one of the disciplines of ]. Clinical testing has shown that this practice is safe and beneficial with no significant side effects.<ref name="PapsinB">{{cite journal |author=Papsin B, McTavish A |title=Saline nasal irrigation: Its role as an adjunct treatment |journal=Can Fam Physician |volume=49 |issue= |pages=168–73 |year=2003 |month=February |pmid=12619739 |pmc=2214184 |doi= |url=http://www.cfp.ca/cgi/pmidlookup?view=long&pmid=12619739}}</ref><ref name="RabagoD">{{cite journal |author=Rabago D, Zgierska A, Mundt M, Barrett B, Bobula J, Maberry R |title=Efficacy of daily hypertonic saline nasal irrigation among patients with sinusitis: a randomized controlled trial |journal=J Fam Pract |volume=51 |issue=12 |pages=1049–55 |year=2002 |month=December |pmid=12540331 |doi= |url=http://www.jfponline.com/Pages.asp?AID=1355}}</ref> | |||
| ==Medical uses== | |||
| The simplest technique is to snort water from cupped hands. Spraying the solution into the nostrils is more convenient, but also less effective. The most effective methods ensure that the liquid enters through one nostril and then either runs out of the other nostril or goes through the ] to the back of the ] from where it may be spat out. The necessary pressure comes from gravity, from condensing a plastic bottle or a ], or from an electrical pump.<!--The reference is only for the efficacy claims.--><ref name=" Olson DE">{{cite journal | |||
| ]) is required.]] | |||
| | last = Olson | |||
| ] | |||
| | first = DE | |||
| | coauthors = Rasgon BM, Hilsinger, RL Jr. | |||
| | title = Radiographic comparison of three methods for nasal saline irrigation | |||
| | journal = Laryngoscope. | |||
| | volume = 112 | |||
| | issue = 8 Pt 1 | |||
| | pages = 1394–98 | |||
| | publisher = | |||
| |date= 2002 Aug | |||
| | pmid = 12172251 | |||
| | accessdate = | |||
| | doi = 10.1097/00005537-200208000-00013 }}</ref> | |||
| Nasal irrigation can be an effective therapy to relieve symptoms of acute sinusitis caused by ] such as the ].<ref name=Ros2015>{{cite journal |last1=Rosenfeld |first1=RM |last2=Piccirillo |first2=JF |last3=Chandrasekhar |first3=SS |last4=Brook |first4=I |last5=Ashok Kumar |first5=K |last6=Kramper |first6=M |last7=Orlandi |first7=RR |last8=Palmer |first8=JN |last9=Patel |first9=ZM |last10=Peters |first10=A |last11=Walsh |first11=SA |last12=Corrigan |first12=MD |title=Clinical practice guideline (update): adult sinusitis executive summary. |journal=Otolaryngology–Head and Neck Surgery |date=April 2015 |volume=152 |issue=4 |pages=598–609 |pmid=25833927 |doi=10.1177/0194599815574247|doi-access=free }}</ref> The evidence for effectiveness in relieving chronic sinusitis is weak.<ref name=Cochrane2016>{{cite journal |last1=Chong |first1=LY |last2=Head |first2=K |last3=Hopkins |first3=C |last4=Philpott |first4=C |last5=Glew |first5=S |last6=Scadding |first6=G |last7=Burton |first7=MJ |last8=Schilder |first8=AG |title=Saline irrigation for chronic rhinosinusitis. |journal=The Cochrane Database of Systematic Reviews |date=26 April 2016 |volume=4 |pages=CD011995 |doi=10.1002/14651858.CD011995.pub2 |pmid=27115216|url=http://discovery.ucl.ac.uk/1489911/1/Schilder_Chong_et_al-2016-The_Cochrane_library.pdf }} {{open access}}</ref> | |||
| Warm ] is commonly used with a ] such as ]. Sometimes ] is added to help kill bacteria that have accumulated in the nose. ] solutions which are saltier than the nasal fluids are favoured and one study indicated that salt from the ] was especially efficacious.<ref>{{cite journal |author=Friedman M, Vidyasagar R, Joseph N |title=A randomized, prospective, double-blind study on the efficacy of dead sea salt nasal irrigations |journal=Laryngoscope |volume=116 |issue=6 |pages=878–82 |year=2006 |month=June |pmid=16735920 |doi=10.1097/01.mlg.0000216798.10007.76 |url=}}</ref> | |||
| It can also be useful for the temporary relief of the symptoms associated with ].<ref name=Hermelingmeier2012>{{cite journal |last=Hermelingmeier |first=Kristina E. |last2=Weber |first2=Rainer K. |last3=Hellmich |first3=Martin |last4=Heubach |first4=Christine P. |last5=Mösges |first5=Ralph |date=2012-09-01 |title=Nasal irrigation as an adjunctive treatment in allergic rhinitis: a systematic review and meta-analysis |journal=American Journal of Rhinology & Allergy |volume=26 |issue=5 |pages=e119–125 |doi=10.2500/ajra.2012.26.3787 |issn=1945-8932 |pmc=3904042 |pmid=23168142}}</ref> | |||
| == Benefits and uses == | |||
| Nasal irrigation is used to treat a wide range of chronic sinus symptoms; for chronic rhinosinusitis it has been found to be an effective adjunctive therapy. According to patient self-reports it improves quality of life and reduces use of medication, including antibiotics. It is also an effective measure against chronic sinus symptoms induced by work-place exposure to sawdust.<ref name=USP>{{citation|url=http://prod.uspharmacist.com/continuing_education/ceviewtest/lessonid/105757/|title=The Use of Saline Nasal Irrigation in Common Upper Respiratory Conditions|author=David Rabago|journal=US Pharmacist|date=June 1, 2008}}</ref> | |||
| ==Adverse effects== | |||
| There is also evidence that nasal irrigation causes relief for both hay-fever and the common cold. The use of nasal irrigation for the related conditions of ], nasal ] and rhinitis of ] has not been assessed but the symptoms of these conditions are expected to be alleviated in a similar way.<ref name=USP /> | |||
| Adverse effects include nasal irritation, nosebleeds, headache, and drainage after the irrigation is done. It is generally well tolerated.<ref name=Cochrane2016/> | |||
| There is a risk of infection if the water is not sterile or the device is not cleaned after use. If the device is used improperly this can be harmful.<ref name=FDA2017>{{cite web |title=Is Rinsing Your Sinuses Safe? |url=https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm316375.htm |website=FDA |date=24 January 2017 |archive-url=https://web.archive.org/web/20190104231633/https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm316375.htm |archive-date=4 January 2019}}</ref> In fact, proper application suggests the use of boiled water or ]. In 2018, a patient was reported to have contracted '']'' after one month of using ] filtered through a ] water purifier for nasal irrigation.<ref>{{cite web |title=Fatal Balamuthia mandrillaris brain infection associated with improper nasal lavage |url=https://www.ijidonline.com/article/S1201-9712(18)34525-9/fulltext |publisher=International Journal of Infectious Diseases |website=IJID Online |date=December 2018}}</ref> | |||
| Daily nasal irrigation with salt water is recommended as both an adjunctive<ref name="pmid16025044">{{cite journal | |||
| |author=Rabago D, Pasic T, Zgierska A, Mundt M, Barrett B, Maberry R |title=The efficacy of hypertonic saline nasal irrigation for chronic sinonasal symptoms |journal=Otolaryngol Head Neck Surg |volume=133 |issue=1 |pages=3–8 |year=2005 |month=July |pmid=16025044 |doi=10.1016/j.otohns.2005.03.002 | |||
| }}</ref> and primary treatment<ref name=gob>{{cite journal |author=Brown CL, Graham SM |title=Nasal irrigations: good or bad? |journal=Curr Opin Otolaryngol Head Neck Surg |volume=12 |issue=1 |pages=9–13 |year=2004 |month=February |pmid=14712112 |doi= 10.1097/00020840-200402000-00004|url=http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=1068-9508&volume=12&issue=1&spage=9}}</ref> in such cases and is preferable to the use of ] or ] except in the most serious cases of acute bacterial sinusitis which should be immediately referred to an ].<ref>{{citation|url=http://www.jfponline.com/pdf%2F5707%2F5707JFP_PURLs.pdf|format=PDF|title=Patients insist on antibiotics for sinusitis? Here is a good reason to say “no”|author=Sarah-Anne Schumann, John Hickner|volume=57|number=7|date=July 2008|journal=The Journal of Family Practice}}</ref> | |||
| In several countries, the sale of over-the-counter medicines for coughs and colds has been banned for infants under the age of two. Nasal irrigation is a useful safe alternative for relieving the symptoms of such young patients.<ref>{{citation|url=http://fda-news.newslib.com/story/6960-39012/|publisher=The Jackson Sun|title=FDA ban on children's decongestants not a whim | |||
| |date=August 4, 2008|author=Tracie Simer}}</ref><ref>{{citation|url=http://www.medicalnewstoday.com/articles/101874.php|title=Infant Cough And Cold Remedies Taken Off Shelves In UK|publisher=Medical News Today|date=27 March 2008}}</ref> | |||
| Rare cases of fatal ] have occurred due to nasal insufflation of the amoeba '']'' (the "brain-eating amoeba") from untreated tap water. Two people died from ''Naegleria fowleri'' infections tied to using neti pots containing tap water in 2011.<ref name="ABC-Neti">{{cite news |last=Moisse |first=Katie |date=16 December 2011 |title=Louisiana Issues Neti Pot Warning After Two Fatal Infections |url=https://abcnews.go.com/Health/Wellness/fatal-infections-linked-neti-pots/story?id=15170230 |url-status=live |work=ABC News |archive-url=https://web.archive.org/web/20190122224915/https://abcnews.go.com/Health/Wellness/fatal-infections-linked-neti-pots/story?id=15170230 |archive-date=22 January 2019 |access-date=17 May 2020 }}</ref> A ] man died from the same amoeba in 2013.<ref>{{cite news |title=Brain infection from water amoeba kills 3; victim used 'neti pot' |url=https://www.king5.com/article/mobile/news/health/brain-infection-from-water-amoeba-kills-3-victim-used-neti-pot/308001356 |access-date=21 January 2021 |publisher=King-TV |date=January 4, 2013}}</ref> | |||
| Flushing the nasal cavity with salt water (saline) promotes ] by moisturizing the nasal cavity and by removing encrusted material. The procedure has been used safely for both adults and children, and has no documented serious adverse effects. Patients treated with nasal irrigation rely less on other medications and make fewer visits to physicians. Treatment guidelines in both Canada and the United States now advocate use of nasal irrigation for all causes of rhinosinusitis and for postoperative cleaning of the nasal cavity.<ref name=Papsin >{{cite journal | |||
| | author=Papsin, B., McTavish, A. | title= Saline nasal irrigation: Its role as an adjunct treatment| journal=Canadian Family Physician | year=2003 | pages=168–173 | volume=49 | issue=February | id=PMID PMC2214184}}</ref> | |||
| ==Mechanism of action== | |||
| == Pulsating nasal irrigation == | |||
| Flushing the nasal cavity can soothe inflamed tissue and remove irritants like allergens; it may help clear mucus.<ref name=Cochrane2016/><ref name=Hermelingmeier2012/> | |||
| Several medical reports indicate pulsatile lavage is more effective than non-pulsating nasal wash products like bulb syringes, neti pots and squeeze bottles which rely simply on gravity and conventional flow at breaking down biofilm, general cleansing and removing bacteria.<ref name=" Osguthorpe JD, Hadley JA ">{{cite journal | |||
| | last = Osguthorpe | |||
| | first = JD | |||
| | coauthors = Osguthorpe David J MD, Hadley James A. MD, FACS | |||
| | title = Rhinosinusitis: Current Concepts in Evaluation and Management | |||
| | journal = Medical Clinics of North America | |||
| | volume = 83 | |||
| | issue = (1) | |||
| | pages = 27-41 | |||
| | publisher = | |||
| |date= 1999 Jan | |||
| | url = http://www.ncbi.nlm.nih.gov/pubmed/9927958?ordinalpos=5&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum | |||
| | id = PMID: 9927958 | |||
| | accessdate = }}</ref> | |||
| <ref name=" Tomooka LT, Murphy C, Davidson TM ">{{cite journal | |||
| | last = Davidson | |||
| | first = TM | |||
| | coauthors = Tomooka LT, Murphy C School of Medicine, University of California San Diego, USA. | |||
| | title = Clinical study and literature review of nasal irrigation. ”The objective of this study was to determine the efficacy of the use of pulsatile hypertonic saline nasal irrigation in the treatment of sinonasal disease”. | |||
| | journal = Laryngoscope | |||
| | volume = 110 | |||
| | issue = (7) | |||
| | pages = 1189-93 | |||
| | publisher = | |||
| |date= 2000 Jul | |||
| | url = http://www.ncbi.nlm.nih.gov/pubmed/10892694?ordinalpos=&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.SmartSearch&log$=citationsensor | |||
| | id = PMID: 10892694 | |||
| | accessdate = }}</ref> | |||
| <ref name="Kaliner MA et al">{{cite journal | |||
| | last = Kaliner | |||
| | first = MA | |||
| | coauthors = Osguthorpe JD, Fireman P, Anon J, Georgitis J, Davis ML, Naclerio R, Kennedy D | |||
| | title = Sinusitis: Bench to Bedside “Pulsatile sinus irrigation is recommended as a treatment for sinusitis, and as a supplement to other treatment modalities” | |||
| | journal = Otolaryngology | |||
| | volume = 116 Part 2 Study of Sinusitis | |||
| | issue = (6) | |||
| | pages = | |||
| | publisher = | |||
| |date= 1997 June | |||
| | url = http://www.ncbi.nlm.nih.gov/pubmed/9212028?ordinalpos=4&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum | id = PMID: 9212028 | |||
| | accessdate = }}</ref> | |||
| Typical use involves the pouring or pumping of saline water through one nostril and letting it drain from the other. | |||
| == Solutions used for nasal irrigation == | |||
| The normal concentration of ] used for medical purposes is 0.9% which can be made by adding 9 grams of ] to one litre of lukewarm water. This concentration is also known as ]. | |||
| ==Solutions and devices== | |||
| ==Jala neti== | |||
| ===Solutions=== | |||
| ], ], or ].]] | |||
| The water should not be tap water, which may contain small amounts of bacteria that are safe to drink but may be dangerous in the nose. The water should be sterile or filtered for micro-organisms; if tap water is used it should be boiled and cooled.<ref name=FDA2017/> ] is also sometimes used.<ref name=Cochrane2016/> | |||
| Nasal irrigation is an ancient ] technique known as ''jala neti'', which literally means ''nasal cleansing with water'' in ], where the practitioner uses a '''neti pot''' to perform the irrigation. Because modern medicine has long supported the use of nasal irrigation to clear sinuses and prevent sinus and nasal conditions, ]s also accept ''jala neti'' as simply one type of nasal irrigation, which can be performed using a neti pot or syringe.{{Fact|date=August 2008}} | |||
| The U.S. ] has a fact sheet recommending one of four methods to make the water safe:<ref name="CDC-Fact-Sheet">{{cite web |url=https://www.cdc.gov/parasites/naegleria/pdf/naegleria-ritual-ablution-factsheet.pdf |title=Safe Ritual Nasal Rinsing |author=<!--Not stated--> |website=CDC.gov |publisher=] |access-date=17 May 2020 |archive-url=https://web.archive.org/web/20190618181911/https://www.cdc.gov/parasites/naegleria/pdf/naegleria-ritual-ablution-factsheet.pdf |archive-date=18 June 2019}}</ref> | |||
| A related technique for nasal cleansing in the yogic tradition, is '''Sutra Neti'''. One end of a cord, or rubber catheter, is passed from the nose into the back of the throat where it is grabbed by the fingers and pulled out of the mouth. Holding the nose end of the cord with one hand and the mouth end with the other, the cord is gently pulled to and fro. | |||
| # Boil: Use water that has been previously boiled for 1 minute and left to cool. At elevations above 6,500 feet, boil for 3 minutes. | |||
| # Filter: Use a filter designed to remove some water-loving germs. The label may read "NSF 53" or "NSF 58". Filter labels that read "absolute pore size of 1 micron or smaller" are also effective. | |||
| # Buy: Use water with a label specifying that it contains distilled or sterile water. | |||
| # Disinfect: Learn how to disinfect your water to ensure it is safe from ''Naegleria''. Chlorine bleach used at the right level and time will work as a disinfectant against this germ. | |||
| A number of other compounds may be included in irrigation fluids such as the steroid ] in an effort to treat chronic ].<ref>{{cite book|last1=Thaler|first1=Erica|last2=Kennedy|first2=David W.|title=Rhinosinusitis: A Guide for Diagnosis and Management|date=2009|publisher=Springer Science & Business Media|isbn=9780387730622|page=82|url=https://books.google.com/books?id=LFQSZR71rGAC&pg=PA82|language=en}}</ref> | |||
| ===Devices=== | |||
| ] | |||
| Neti pots are commonly used and rely on gravity and head position in order to rinse the outer sinus cavities. Typically they have a spout attached near the bottom, sometimes with a handle on the opposite side.<ref name=FDA2017/> | |||
| Various squeeze bottles for nasal irrigation have also been used to apply the water.<ref name=FDA2017/> | |||
| Bulb syringes are commonly used for infants and children.<ref name=FDA2017/> | |||
| There are also irrigation machines available that utilize electric motor-driven pumps.<ref name=FDA2017/> | |||
| ==History== | |||
| {{More citations needed|section|date=February 2018}} | |||
| The earliest record of nasal irrigation is found in the ancient ] practice of Indian ] whose roots are traced to the ]. It was customary to perform jala-neti daily, as part of ''soucha'' (personal hygiene according to scriptures). '']'', which means to cleanse the nose with water, is an old yogic technique from India. The container used to administer the saline is called a "neti pot". This process removes mucus and dirt and clears the nose. A second neti technique known as '']'' uses a piece of string instead of water. | |||
| ==See also== | ==See also== | ||
| {{Portal|Medicine}} | |||
| * ] | |||
| * ] | * ] | ||
| * ] | * ] | ||
| * ] | |||
| ==References== | ==References== | ||
| {{ |
{{Reflist|32em}} | ||
| * Neti: Healing Secrets of Yoga and Ayurveda, Dr. David Frawley, Lotus Press, Twin Lakes, WI ISBN 0940985853 | |||
| ==External links== | ==External links== | ||
| {{wikibooks|1=Ethnomedicine|2=Home Remedies/Saline Nasal Wash|3=Saline Nasal Wash}} | |||
| * | * | ||
| * | |||
| * | |||
| {{Authority control}} | |||
| {{DEFAULTSORT:Nasal irrigation}} | |||
| ] | ] | ||
| ] | ] | ||
| ] | |||
| ] | |||
| ] | |||
| ] | |||
| ] | |||
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Latest revision as of 03:44, 28 April 2024
Personal hygiene practice for rinsing out nasal passagesMedical intervention
| Nasal irrigation | |
|---|---|
 Woman flushing her nose with a neti pot | |
| ICD-9-CM | 22.0 |
| MeSH | D055556 |
| [edit on Wikidata] | |
Nasal irrigation (also called nasal lavage, nasal toilet, or nasal douche) is a personal hygiene practice in which the nasal cavity is washed to flush out mucus and debris from the nose and sinuses, in order to enhance nasal breathing. Nasal irrigation can also refer to the use of saline nasal spray or nebulizers to moisten the mucous membranes.
Medical uses
Nasal irrigation can be an effective therapy to relieve symptoms of acute sinusitis caused by upper respiratory tract infections such as the common cold. The evidence for effectiveness in relieving chronic sinusitis is weak.
It can also be useful for the temporary relief of the symptoms associated with allergic rhinitis.
Adverse effects
Adverse effects include nasal irritation, nosebleeds, headache, and drainage after the irrigation is done. It is generally well tolerated.
There is a risk of infection if the water is not sterile or the device is not cleaned after use. If the device is used improperly this can be harmful. In fact, proper application suggests the use of boiled water or saline water. In 2018, a patient was reported to have contracted Balamuthia mandrillaris after one month of using tap water filtered through a Brita water purifier for nasal irrigation.
Rare cases of fatal naegleriasis have occurred due to nasal insufflation of the amoeba Naegleria fowleri (the "brain-eating amoeba") from untreated tap water. Two people died from Naegleria fowleri infections tied to using neti pots containing tap water in 2011. A Louisiana man died from the same amoeba in 2013.
Mechanism of action
Flushing the nasal cavity can soothe inflamed tissue and remove irritants like allergens; it may help clear mucus.
Typical use involves the pouring or pumping of saline water through one nostril and letting it drain from the other.
Solutions and devices
Solutions
The water should not be tap water, which may contain small amounts of bacteria that are safe to drink but may be dangerous in the nose. The water should be sterile or filtered for micro-organisms; if tap water is used it should be boiled and cooled. Saline solution is also sometimes used.
The U.S. Centers for Disease Control and Prevention has a fact sheet recommending one of four methods to make the water safe:
- Boil: Use water that has been previously boiled for 1 minute and left to cool. At elevations above 6,500 feet, boil for 3 minutes.
- Filter: Use a filter designed to remove some water-loving germs. The label may read "NSF 53" or "NSF 58". Filter labels that read "absolute pore size of 1 micron or smaller" are also effective.
- Buy: Use water with a label specifying that it contains distilled or sterile water.
- Disinfect: Learn how to disinfect your water to ensure it is safe from Naegleria. Chlorine bleach used at the right level and time will work as a disinfectant against this germ.
A number of other compounds may be included in irrigation fluids such as the steroid budesonide in an effort to treat chronic rhinosinusitis.
Devices
Neti pots are commonly used and rely on gravity and head position in order to rinse the outer sinus cavities. Typically they have a spout attached near the bottom, sometimes with a handle on the opposite side.
Various squeeze bottles for nasal irrigation have also been used to apply the water.
Bulb syringes are commonly used for infants and children.
There are also irrigation machines available that utilize electric motor-driven pumps.
History
 | This section needs additional citations for verification. Please help improve this article by adding citations to reliable sources in this section. Unsourced material may be challenged and removed. Find sources: "Nasal irrigation" – news · newspapers · books · scholar · JSTOR (February 2018) (Learn how and when to remove this message) |
The earliest record of nasal irrigation is found in the ancient Hindu practice of Indian Ayurveda whose roots are traced to the Vedas. It was customary to perform jala-neti daily, as part of soucha (personal hygiene according to scriptures). Jala neti, which means to cleanse the nose with water, is an old yogic technique from India. The container used to administer the saline is called a "neti pot". This process removes mucus and dirt and clears the nose. A second neti technique known as sutra neti uses a piece of string instead of water.
See also
References
- Rosenfeld, RM; Piccirillo, JF; Chandrasekhar, SS; Brook, I; Ashok Kumar, K; Kramper, M; Orlandi, RR; Palmer, JN; Patel, ZM; Peters, A; Walsh, SA; Corrigan, MD (April 2015). "Clinical practice guideline (update): adult sinusitis executive summary". Otolaryngology–Head and Neck Surgery. 152 (4): 598–609. doi:10.1177/0194599815574247. PMID 25833927.
- ^ Chong, LY; Head, K; Hopkins, C; Philpott, C; Glew, S; Scadding, G; Burton, MJ; Schilder, AG (26 April 2016). "Saline irrigation for chronic rhinosinusitis" (PDF). The Cochrane Database of Systematic Reviews. 4: CD011995. doi:10.1002/14651858.CD011995.pub2. PMID 27115216. [REDACTED]
- ^ Hermelingmeier, Kristina E.; Weber, Rainer K.; Hellmich, Martin; Heubach, Christine P.; Mösges, Ralph (1 September 2012). "Nasal irrigation as an adjunctive treatment in allergic rhinitis: a systematic review and meta-analysis". American Journal of Rhinology & Allergy. 26 (5): e119–125. doi:10.2500/ajra.2012.26.3787. ISSN 1945-8932. PMC 3904042. PMID 23168142.
- ^ "Is Rinsing Your Sinuses Safe?". FDA. 24 January 2017. Archived from the original on 4 January 2019.
- "Fatal Balamuthia mandrillaris brain infection associated with improper nasal lavage". IJID Online. International Journal of Infectious Diseases. December 2018.
- Moisse, Katie (16 December 2011). "Louisiana Issues Neti Pot Warning After Two Fatal Infections". ABC News. Archived from the original on 22 January 2019. Retrieved 17 May 2020.
- "Brain infection from water amoeba kills 3; victim used 'neti pot'". King-TV. 4 January 2013. Retrieved 21 January 2021.
- "Safe Ritual Nasal Rinsing" (PDF). CDC.gov. Centers for Disease Control and Prevention. Archived from the original (PDF) on 18 June 2019. Retrieved 17 May 2020.
- Thaler, Erica; Kennedy, David W. (2009). Rhinosinusitis: A Guide for Diagnosis and Management. Springer Science & Business Media. p. 82. ISBN 9780387730622.
External links
- University of Wisconsin instructions, study and video
- Saline nasal irrigation: Its role as an adjunct treatment