In ENT clinical practice, sinus irrigation is becoming increasingly popular as an important adjunctive treatment. This technique, which injects a solution into the sinus cavity at a specific pressure, not only directly clears secretions from the affected area but also promotes mucosal recovery through physical stimulation.
Deep Cleansing
The sinuses, air-filled bony cavities surrounding the nasal cavity, have openings of only 2-4 mm and are easily clogged by viscous secretions. Studies have shown that the concentration of inflammatory factors such as interleukin-6 in the purulent secretions accumulated in the sinuses of patients with chronic sinusitis is 15-20 times higher than in normal tissue. Sinus irrigation, through the high-pressure infusion of saline, effectively dilutes and flushes out these inflammatory substances, reducing the bacterial load within the sinus cavity by 70%-90%. For patients undergoing maxillary sinus puncture and irrigation, daily nasal irrigation after surgery can increase the sinus patency rate from 62% to 89%.
Mucosal Repair
The sinus mucosa is covered with cilia that beat 1,000-1,500 times per minute. These "biological brooms" form the nasal cavity's first line of defense. Chronic inflammation can cause cilia to collapse, resulting in a 40%-60% decrease in beat frequency. Clinical observations have shown that patients who consistently use sinus irrigation can recover 85% of their normal mucociliary transport function within three weeks. This is due to the sodium and potassium ions in the irrigation solution, which regulate mucosal osmotic pressure and promote regeneration of the mucus blanket. For patients undergoing endoscopic sinus surgery, irrigation can also soften blood crusts, reducing the incidence of postoperative adhesions from 18% to less than 5%.
Symptom Relief
Sinus irrigation is significantly effective in improving typical symptoms:
Nasal congestion relief: By clearing secretions that clog the sinus ostiae, nasal airflow can increase by 30%-50%, and patients' subjective nasal congestion scores can decrease by 2-3 levels (on a 0-10 scale).
Headache relief: After reducing sinus pressure, 76% of patients with chronic sinusitis headaches report a greater than 50% reduction in pain frequency. Restoring Olfactory Sense: After flushing to remove corrupted matter from the sinus cavity, olfactory threshold test scores increased by an average of 40%, with particularly significant results for patients with fungal sinusitis.
Improving Sleep: Relief of nighttime nasal congestion reduces the patient's sleep apnea-hypopnea index (AHI) by 15-20 events per hour, and morning dry mouth and headache symptoms are significantly improved.
Drug Synergy: Building a Therapeutic Collaborative Network
Irrigation solutions can serve as drug carriers for precise drug delivery. For refractory sinusitis, adding 0.05% budesonide to the irrigant can increase the drug concentration in the sinus cavity to 8-10 times that of traditional nasal sprays, extending the duration of action to 6-8 hours. Clinical studies have shown that this combination of irrigation and topical corticosteroids can increase the rate of symptom score reduction by 40% and shorten the treatment cycle by 30%. For patients with coexisting asthma, irrigation can also reduce nasal secretion backflow, improving the control rate of lower airway inflammation by 25%.
Preventing Relapses
Regular irrigation can significantly reduce the recurrence rate of sinusitis. A three-year follow-up of 500 patients with chronic sinusitis found that those who consistently rinsed 2-3 times weekly had an annual recurrence rate of only 12%, compared to 38% in the non-irrigation group. This preventive effect stems from irrigation's modulating effect on the nasal microbiome—by eliminating pathogenic bacteria while preserving normal flora, it increases the diversity index of nasal colonizing bacteria by 1.8 times, creating a more stable microbial barrier. For children, irrigation can also reduce the number of days of antibiotic use and the risk of developing drug-resistant bacteria.
Scientific Irrigation: Precautions and Contraindications
Although sinus irrigation offers significant benefits, it must be carefully considered within its intended use:
Procedure: Irrigation pressure should be maintained at 12-15 kPa, water temperature maintained at 32-35°C, and irrigation volume should not exceed 250 ml per session.
Contraindications: Contraindicated in patients with active epistaxis, severe septal deviation, or skull base fracture; caution is advised during acute otitis media.
Prevention of complications: Avoid swallowing during irrigation to prevent fluid from entering the middle ear through the Eustachian tube. Stop irrigation immediately and seek medical attention if ear pain or epistaxis occurs.
From anatomical cleansing to functional reconstruction, from symptom control to disease prevention, sinus irrigation is reshaping the treatment paradigm for nasal diseases. For every sinusitis patient, it is not just a simple cleaning action, but a micro-revolution in rebuilding the nasal cavity ecology.
