Many people have encountered the unpleasant choking experience during swimming, so whenever an ENT doctor recommends washing their nose with saline water to treat patients with sinusitis, allergic rhinitis or cold, many people are terrified about the idea. Will it feel like choking during swimming lessons? However, patients are generally surprised at the comfort they experienced during use. Since ancient times, India yoga practitioners and Chinese Taoists are encouraged to fill their hands with water every morning, inhale the water, then spit out water from the mouth, and thereby clean their noses and nasal cavities, and to achieve an effective health care. But most people cannot easily adopt such practice, as one will face headache and choking experience.
So why do patients enjoy pulsatile nasal irrigation with warm saline water, but experience unpleasant headache when choking during swimming or inhale normal water like the yoga practitioner. There is nothing magical (although I sure hope there is) about pulsatile nasal irrigator. The difference occurs with the use of warm saline water as compared to normal water. The two key points are the concentration and temperature of the nasal tissue fluid, which is similar to that of warm saline water.
In medicine, saline water is usually use to simulate the concentration of nasal tissue fluid. Normal water is a hypotonic solution to saline water and nasal tissue, thus washing your nasal cavity with normal water will not only cause you pain and headache but may also lead to edema and nasal mucosa damages. When hypotonic solution (water) enters the nasal cavity, the ions in nasal mucosal tissue fluid will leave the nasal mucosa and diffuse into the water, and water will also penetrate the nasal cavity into the nasal mucosa and cause mucosal edema. This is why the otolaryngologists recommend that patients to use warm saline water to wash their noses.
In fact, relative to the nasal tissue fluid, the so-called Ringer solution is much closer to its true concentration than regular saline water. However, because it is not convenient and practical for ordinary people to prepare Ringer solution, it is usually recommended to use warm saline water or isotonic saline solution to wash the nose. Isotonic solution is made by adding baking soda to the regular saline water to make it more alkaline and achieve maximum comfort. The recipe saline solution is simple: for regular saline solution, simply add 9 grams of Non-iodized high quality salt to 1000cc of warm water; for isotonic saline solution, simply add 6 grams of Non-iodized high quality salt and 3 grams of baking soda to warm water. high salt, the salt water and of water was added 1000cc 6 grams of edible salt and 3 grams of high-level roasting and baking soda (no need to use expensive low-sodium salt, seasoning salt or natural salt, because they are less comfortable to use, and the results are not comparably better).
We envy people who can swim in the cold winter, but it requires extensive training to do so. Similarly, the most suitable water temperature to wash the nose is close to the nasal cavity temperature, which is 37 ℃, so we usually recommend using 35 ℃ -38 ℃ of warm saline water to rinse the nose. Ancient India yoga practitioners use cold water in the range of 10 ℃ -20 ℃. People who are not use to probably couldn’t even stand showering at this temperature range, let alone washing the sensitive nasal mucosa with it! Even the heated swimming pool in general, with a water temperature of 30 ℃ is not comfortable for the nasal mucosa.
Nasal mucosa is very sensitive to temperature, because it must provide the air inside the lungs bronchial more stable temperature and humidity. So when the cold air into the nasal cavity, the nasal mucosa swelling naturally, on the one hand to reduce the flow into the air, on the other hand by swelling of the mucous membrane, the temperature and humidity to provide more air to enter. Yet more than 48 ℃ hot water, can also cause nasal swelling and damage. It is usually best to rinse the nasal cavity between the water temperature between 35 ℃ -38 ℃.
Shyhung Clinic, Dr. Tseng Hung-cheng