Using water to wash nose has long been one of the health regimen of the Chinese Taoist and India yoga. The method is done by holding clean water with both hands, head bent, inhaled the water and then spit out the water from the mouth to clear and clean the dirt in the nasal cavity. This method is simple, but at the beginning of practice, many people experience headache and choking, thus discontinue this practice. From the perspective of modern medicine, in addition to the discomfort, the use of normal water (hypotonic solution) in general may cause pain and ultimately cause damage to one’s nasal mucosa.
Current nasal irrigator are based on these ancient regimen. Simple nasal irrigator on the market can be divided into squeeze bottle and neti pot. Although some patients with the squeeze bottle feel the stronger pressure could wash their nasal cavity more thoroughly, the risk is high, as the high pressure may likely cause pain and bleeding nasal injuries, and even, occasionally and unfortunately, cause cerebrospinal rupture and fluid outflow. On the other hand, nasal irrigation using neti pot is done by gravitational force, which is more gentle and safer than squeeze bottle, and could effectively moisturize your nasal cavity, but it is less effective to clean. Another disadvantage is that as the users tilt their head, according to the human anatomy, the water could easily flow into the middle ear cavity and throat.
As of a number of nasal spray or steam-type nasal wash on the market, strictly speaking are not considered as nasal cleaning devices, because they do not actually wash the nasal cavity, instead they simply moisturize the nasal mucosa. To distinguish between a real nasal irrigator and a moisturizer is very simple, the general nasal irrigation uses at least 200cc-500cc of water to clean the nasal cavity, while the moisturizer only uses about 5cc – 10cc of water. Smart readers like you could easily understand that how would 5cc – 10cc of water be enough to clean the debris from your nose and sinuses. This is why many patients complain about these so-called nasal wash moisturizer after they spend their hard earned money on it, but only after several uses do they realize that it doesn’t wash out debris as advertised by its retailer. Medical studies have shown that these nasal sprays and moisturizers do not spray deep into the sinuses and provide far less effective treatment to sinusitis patients than an actual nasal irrigator.
The Pulsatile Nasal Irrigation can be said to be the most advanced nasal irrigation method, which is based on anatomy and physiology of nasal mucociliary function and motor function (mucociliary movement). It can irrigate warm saline water into one of the nasal passage through the nasal cavity, paranasal sinuses, nasopharynx, and come out from the other nasal passage. Since it doesn’t have the strong pressure as the squeeze bottle, the water flow is gentle, so it is safe and will not cause injury or bleeding nasal mucosa. More over, the water flow pulsates at frequencies similar to that of the natural mucociliary movement, it can more effectively remove thick mucus and pus bacterial toxins. During use, your head should bend down, which from the anatomical point of view, it is easy for the water to flow into the nasal cavity from one side, around the nasopharynx and exit from the other side. It also suggests a much lower chance to flow into Eustachian tube or throat, and in turn, the patient would feel more comfortable. This is why many doctors and patients choose and continue to use the pulsating nasal irrigation device after several uses of different methods. Many ENT doctors (including me), thought the difference is minimal before actually using one. It was not until we’ve personally used it and observed the effects on many patients after several uses, did we truly understand the huge difference between a pulsating nasal irrigation and the others.
Shyhung Clinic, Dr. Tseng Hung-cheng