During an acute sinusitis attack, patients are often troubled by symptoms such as nasal congestion, purulent nasal discharge, and facial swelling and pain. In severe cases, it may even be accompanied by fever and headache, affecting daily life and work. Many patients try to relieve discomfort by rinsing their nasal cavity, but does this method really speed up recovery? Based on clinical research and medical practice, nasal irrigation does play an important role in the treatment of acute sinusitis, but its role and applicable scenarios need to be viewed scientifically.
Three Core Functions of Nasal Irrigation
Physical Removal of Pathogens and Secretions
The typical pathological feature of acute sinusitis is swelling of the sinus mucosa and increased secretions, leading to blockage of the sinus ostia and the accumulation of pus. Nasal irrigation, through the flushing action of physiological saline or special irrigation solutions, can directly remove purulent secretions, allergens (such as dust mites and pollen), and some pathogens from the nasal cavity and sinuses. For example, using budesonide suspension combined with physiological saline irrigation can not only clear purulent nasal discharge but also reduce mucosal inflammation and promote sinus ostia opening through the hormonal components. Clinical data shows that rinsing 2-3 times daily can significantly reduce the bacterial load in the nasal cavity and lower the risk of secondary infections.
Improves Nasal Ventilation and Drainage
Sinus ventilation depends on the connectivity between the sinus ostia and the nasal cavity. When the sinus ostia are blocked due to inflammation and swelling, the rinsing solution can dilate the ostia through pressure, promoting pus drainage. A study on acute sinusitis in children showed that after rinsing with 37°C isotonic saline, 72% of patients experienced relief of nasal congestion within 24 hours, and nasal ventilation increased by more than 40%. Furthermore, maintaining a moist nasal environment after rinsing can reduce irritation caused by mucosal dryness, further improving respiratory function.
Enhances the Efficacy of Adjunctive Drug Treatment
Nasal irrigation is often used in combination with antibiotics and nasal corticosteroids. For example, while oral amoxicillin-clavulanate potassium controls bacterial infection, irrigation can remove deep pus that is difficult for medication to reach, allowing antibiotics to act more directly on the lesions. For patients with concurrent allergic rhinitis, nasal irrigation can reduce allergen residue, decrease the dosage of antihistamines (such as loratadine), and shorten the treatment cycle.
Limitations of Nasal Irrigation
Although nasal irrigation is effective, its role has limitations:
It cannot replace antibiotics: If acute sinusitis is caused by bacterial infection (such as streptococcus or Staphylococcus aureus), simple irrigation cannot kill the pathogens and requires combination therapy with penicillin or cephalosporin antibiotics.
It is ineffective for severe anatomical abnormalities: If the patient has structural problems such as deviated nasal septum or nasal polyps causing permanent blockage of the sinus ostia, irrigation can only relieve symptoms; endoscopic sinus surgery is needed to correct the anatomical structure for a complete cure.
Proper operation is required to avoid complications: Excessively high water temperature (>40℃) during irrigation may damage the mucosa, and excessive pressure may lead to ear infections (such as otitis media). It is recommended to use a dedicated irrigator, maintain mouth breathing, and gently blow your nose after irrigation.
Practical Guidelines for Scientific Nasal Irrigation
Frequency and Timing
Acute Phase (Peak Symptom Period): 2-3 times daily for one week until symptoms significantly improve.
Resuscitation Phase: Once daily or every other day to maintain nasal cleanliness.
Children: Parental supervision is required to prevent choking. A spray-type irrigator is preferred.
Solution Selection
Ordinary purulent nasal discharge: 0.9% isotonic saline or sea salt solution, gentle and non-irritating.
Severe nasal congestion with mucosal swelling: 2%-3% hypertonic saline solution, which can help reduce swelling, but should not be used for more than 7 days.
Concurrent Allergies: Hormonal components such as budesonide can be added, but the dosage should be determined under the guidance of a doctor.
Recommended Combined Treatment
Bacterial Infection: Irrigation + antibiotics (e.g., cefuroxime axetil) + mucolytics (e.g., cineole enteric-coated soft capsules).
Allergic Factors: Irrigation + antihistamines (e.g., loratadine) + nasal corticosteroids (e.g., mometasone furoate nasal spray). Physical therapy: Apply warm compresses to the face (3 times daily, 15 minutes each time) + steam inhalation (with menthol added to hot water).
When should you be wary of ineffective nasal irrigation?
If the following situations occur, it indicates that the condition may be progressing or the treatment plan needs to be adjusted:
The amount of purulent nasal discharge does not decrease after irrigation; fever persists for >3 days;
Facial pain worsens, accompanied by bulging eyes and blurred vision (possible orbital infection);
Severe headache, accompanied by nausea and vomiting (possible intracranial infection).
In these cases, immediate medical attention is necessary, and a sinus CT scan may be required to assess whether surgical intervention is needed.
Recovery from acute sinusitis is a comprehensive process involving "cleaning care + medication control + structural correction." Nasal irrigation, as a first-line adjunctive therapy, can significantly accelerate symptom relief, but it must be strictly followed according to the operating procedures and coordinated with the treatment plan prescribed by the doctor. For patients, scientifically understanding the limitations of irrigation and avoiding blind reliance or rejection is key to achieving faster recovery.
