| Sinus Irrigation |
 |
I often advise patients to obtain a Grossan nasal irrigator - a tip to place into the nose; it can be purchased with a special irrigation device from Hydromed (the Hydropulse; 1-800-560-9007). Saline is usually used in the device. Packets of specially formulated salt can be purchased directly from Hydromed, or you can mix it yourself (may take some attempts to find the right mix): To make saline: boil 1 quart water, add 1 tablespoon of salt: pickling, canning, or regular, and add 1 teaspoon of bicarbonate to reduce any chance of stinging. Let the solution cool before use! Additives can also be placed into the irrigation solution. You would need your physician's approval and prescription for this: Directions for Hydro Pulse Irrigation with Additives. Add one teaspoon of salt to Hydro Pulse Basin. Add warm water to 500 cc and mix. Set the pressure at the nasal tip so that the stream is about one inch high Irrigate the nose 300 cc (about 150 cc each side) to clear the mucus. Stop and gently clear the nose. Add medication to the remaining 200 cc. Irrigate about 100 cc each side till empty. Sit quietly for 10 minutes at the sink. No blowing. Do not blow the nose for 2 hours Some physicians will add 40 mg of Gentamycin to the 200 cc. Others use Tobramycin esp for patients with cystic fibrosis. Some physicians will add 1/2 of a tube of Bactroban to the 200cc (this is hard to dissolve, but it will - keep mixing!). Some physicians are using antifungals, as some research has shown a possible link for chronic rhinosinusitis and fungi. If the discharge is purulent, then the patient may be asked to perform irrigation twice per day. Children have used this regimen successfully. Sitting quietly for 10 minutes keeps the solution in longer. No nose blowing for two hours means less chance of blowing the medicine into the ears via the eustachian tubes. |