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The benefits of seawater
Nasal irrigation & decongestion
The use of nasal irrigation dates back centuries to yogic
and ayurvedic traditions where hypertonic saline solutions
were used for nasal irrigation for purification purposes
as part of the preparation process. Western medicine has
adopted this practice since the 19th century where nasal
irrigation has been recommended for the treatment of sinonasal pathology.
Nasal irrigation and thus cleansing -performed using a
neti pot (neti in Sanskrit means "nasal cleansing"),
nebulizers or most commonly nasal sprays- is being used
extensively in modern medicine to flush out dust, debris,
pollutants, allergens, germs and excess mucus from the
nose and sinuses which can lead to sinonasal blockage and
infection.
Whereas nasal irrigation can be carried out using ordinary
tap water, this is generally felt to be uncomfortable
because it irritates the mucous membranes. Therefore an
isotonic or hypertonic salt water solution is normally
used.
Medical Conclusions
Below you can find some of the medical conclusions for
Hypertonic Seawater. By pressing on the links you may
revert to a summary of the publication.
“Hypertonic seawater solution has been proven to be better
than isotonic seawater solution in eliminating the
symptoms of nasal congestion, rhinorrhea, cough, headache
and waking up during the night… in patients with chronic
rhinosinusitis”.
http://www.ncbi.nlm.nih.gov/pubmed/21258306
Culig J., et al. Efficiency of hypotonic and isotonic sea
water solutions in chronic rhinosinusitis. Medicinski
Glaskik, Vol.7, No.2 Aug. 2010.
“Nasal rinsing with hypertonic saline solution is a safe
and effective treatment option in pregnant women with
seasonal allergic rhinitis.”
www.ncbi.nlm.nih.gov/pubmed/19752567
Garavello W, et al. Nasal lavage in pregnant women with
seasonal allergic rhinitis: a randomized study. Int Arch
Allergy Immunol. 2010;151(2):137-41. Epub 2009 Sep 15.
“Hypertonic solution irrigation using Sinomarin® (2.3%) is
beneficial, since it enables a more rapid action on the
edema, a virtually common characteristic of nasal,
catarrhal, infectious or allergic disorders.”
González G. JA; Sánchez A. Y ; Mejía R. An
investigational, prospective, longitudinal, comparative,
multicentre, open-label study on the efficacy and
tolerability of Sinomarin Spray for the treatment of
rhinitis. Journal of the Federation of Otolaryngological
Colleges and Societies of the Mexican Republic, 2008
“Buffered hypertonic seawater improves nasal airway
patency more than the buffered isotonic saline. Buffered
hypertonic solutions used after endonasal surgery have
been advantageous for both mucociliary clearance and
postoperative decongestion.”
www.ncbi.nlm.nih.gov/pubmed/18802718
Süslü N, et. al. Effects of buffered 2.3%, buffered 0.9%,
and non-buffered 0.9% irrigation solutions on nasal mucosa
after septoplasty. Eur Arch Otorhinolaryngol. 2009
May;266(5):685-9. Epub 2008 Sep 18.
“Patients with frequent rhinosinusitis and daily sinus
symptoms, symptoms of concomitant allergic rhinitis,
asthma, or polyposis may improve with hypertonic saline
nasal irrigation. There is strong evidence that hypertonic
saline nasal irrigation is an effective adjunctive
treatment for symptoms of chronic rhinosinusitis.”
www.ncbi.nlm.nih.gov/pubmed/18593081
Rabago D, Guerard E, Bukstein D. Nasal irrigation for
chronic sinus symptoms in patients with allergic rhinitis,
asthma, and nasal polyposis: a hypothesis generating
study. WMJ. 2008 Apr;107(2):69-75.
“Hypertonic saline decreases the nasal edema and
influences the mucocilliary function through the fluid
secretion in vitro.”
www.ncbi.nlm.nih.gov/pubmed/17869465
Li HB, et. al. . Hypertonic saline solution stimulated
CLC-3 production in primary cultured human nasal
epithelial cells. Auris Nasus Larynx. 2008
Mar;35(1):47-51.
“Nasal irrigation using Hypertonic Sea Water Solution is
recommended for chronic rhinosinusitis. The ENT
professions suggest the use of hypertonic seawater
solution better that hypertonic saline, while hypertonic
solutions give far better results than isotonic saline.”
www.ncbi.nlm.nih.gov/pubmed/18438594
W.J. Fokkens, V.J. Lund, J. Mullol et al., European
Position Paper on Nasal Polyps 2007.
Rhinology 45; suppl. 20: 1-139.
“Nebulized 3% hypertonic saline (HS) is superior to normal
saline; effective treatment for infants hospitalized with
moderately severe viral bronchiolitis”
www.ncbi.nlm.nih.gov/pubmed/17719935
Kuzik BAet. al. Nebulized hypertonic saline in the
treatment of viral bronchiolitis in infants. J Pediatr.
2007 Sep;151(3):266-70, 270.e1. Epub 2007 Jun 29.
www.ncbi.nlm.nih.gov/pubmed/18843717
Zhang L, et. al., Nebulized hypertonic saline solution for
acute bronchiolitis in infants. Cochrane Database Syst
Rev. 2008 Oct 8;(4):CD006458.
“Superiority of Dead Sea Salt over saline nasal irrigation
for treatment of chronic rhinosinusitis”.
http://www.ncbi.nlm.nih.gov/pubmed/16735920
Friedman M, Vidyasagar R, Joseph N. A randomized,
prospective, double-blind study on the efficacy of dead
sea salt nasal irrigations. Laryngoscope. 2006
Jun;116(6):878-82.
“Hypertonic saline nasal irrigation is a safe,
well-tolerated, inexpensive, effective, long-term therapy
that patients with chronic sinonasal symptoms”.
www.ncbi.nlm.nih.gov/pubmed/16868232
Rabago D, et. al. Qualitative Aspects of Nasal Irrigation
Use by Patients With Chronic Sinus Disease in a
Multimethod Study. Ann Fam Med. 2006 Jul-Aug;4(4):295-301.
“Participants with chronic sinonasal symptoms reported
improved quality-of-life and frequent, satisfying use of
hypertonic saline nasal irrigation.”
www.ncbi.nlm.nih.gov/pubmed/16025044
Rabago D, et. al. The efficacy of hypertonic saline nasal
irrigation for chronic sinonasal symptoms. Otolaryngol
Head Neck Surg. 2005 Jul;133(1):3-8.
“The administration of hypertonic saline results in a
significantly faster ciliary beat frequency 5 minutes
after administration”
www.ncbi.nlm.nih.gov/pubmed/15867643
Wabnitz DA, Wormald PJ. A blinded, randomized, controlled
study on the effect of buffered 0.9% and 3% sodium
chloride intranasal sprays on ciliary beat frequency.
Laryngoscope. 2005 May;115(5):803-5.
“Buffered hypertonic saline affected saccharine clearance
times (i.e. mucocialiary clearance) to a greater degree
than buffered normal saline.”
www.ncbi.nlm.nih.gov/pubmed/15523448
Keojampa BK, Nguyen MH, Ryan MW. Effects of buffered
saline solution on nasal mucociliary clearance and nasal
airway patency. Otolaryngol Head Neck Surg. 2004
Nov;131(5):679-82.
“When nasal irrigations are combined with other medical
modalities, patients with chronic sinusitis may not
require surgical intervention as often …patients using
hypertonic saline nasal irrigations reported better
outcomes.”
www.ncbi.nlm.nih.gov/pubmed/14712112
Brown CL and Graham SM., “Nasal irrigations: good or bad?”
Current Opinion in Otolarynology & Head and Neck Surgery
12:9-13,2004.
“Nasal lavage with hypertonic saline is a useful
adjunctive treatment in the management of pediatric
seasonal allergic rhinoconjuctivitis”
www.ncbi.nlm.nih.gov/pubmed/15970639
Garavello W, et al. Nasal rinsing with hypertonic
solution: an adjunctive treatment for pediatric seasonal
allergic rhinoconjunctivitis. Int Arch Allergy Immunol.
2005 Aug;137(4):310-4. Epub 2005 Jun 20.
www.ncbi.nlm.nih.gov/pubmed/12675761
Garavello W, et al. Hypersaline nasal irrigation in
children with symptomatic seasonal allergic rhinitis: a
randomized study. Pediatr Allergy Immunol. 2003
Apr;14(2):140-3.
“Hypertonic saline alone evokes mucinous secretion in
human nasal airways in vivo”
www.ncbi.nlm.nih.gov/pubmed/12608446
Greiff L, Andersson M, Wollmer P, Persson CG. Hypertonic
saline increases secretory and exudative responsiveness of
human nasal airway in vivo. Eur Respir J. 2003
Feb;21(2):308-12.
“Daily hypertonic saline nasal irrigation improves
sinus-related quality-of-life, decreases symptoms, and
decreases medication use in patients with frequent
sinusitis.”
www.ncbi.nlm.nih.gov/pubmed/12540331
Rabago D et al., “Efficacy of daily hypertonic saline
nasal irrigation among patients with sinusitis: A
randomised controlled trial”. J. Fam. Pract. 51:1049-1055,
2002.
“Hypertonic saline solutions improve mucociliary
clearance.”
www.ncbi.nlm.nih.gov/pubmed/11122299
Homer JJ, Dowley AC, Condon L, El-Jassar P, Sood S. The
effect of hypertonicity on nasal mucociliary clearance.
Clin Otolaryngol Allied Sci. 2000 Dec;25(6):558-60.
“Nasal irrigation [with hypertonic saline] is effective in
improving symptoms and the health status of patients with
sinonasal disease”
www.ncbi.nlm.nih.gov/pubmed/10892694
Tomooka LT et al., “Clinical study and literature review
of nasal irrigation”. Laryngoscope. 110(7):1189-93, 2000.
“Nasal hypertonic saline irrigation in children <5years
improved symptoms of nasal problems with decrease or
disappearance of pathogenic bacteria after the two weeks
of treatment without the use of antibiotics”
http://sciencelinks.jp/j-east/article/200003/000020000399A0921815.php
Mihoko I. et. al. The effectiveness of nasal irrigation in
the treatment of infant nasal problems. Japanese Journal
of Rhinology 38 (2):230-234, 1999.
“Use of hypertonic seawater (2.3%) is effective on nasal
obstruction (hypertrophic rhinitis, allergic rhinitis,
polyposis, vasomotor rhinitis, purulent rhinitis,
unspecified rhinitis”
Freche et al., “Usefulness of hypertonic seawater (Sinomarin®)
in rhinology. Revue Officielle de la Societe Francaise de
ORL, 50(4), 1998.
“Hypertonic saline nasal wash is an efficient treatment of
chronic sinusitis.”
www.ncbi.nlm.nih.gov/pubmed/9600495
Shoseyov D et al., “Treatment with hypertonic saline
versus normal saline nasal wash of pediatric chronic
sinusitis. J. Allergy Clin. Immunol. 101:602-5, 1998.
"Buffered hypertonic saline nasal irrigation improves
mucociliary transit times of saccharin, while buffered
normal saline had no such effect. Hypertonic saline is
thus superior to buffered normal saline for mucociliary
clearance"
www.ncbi.nlm.nih.gov/pubmed/9111380
Talbot AR et al., “Mucociliary clearance and buffered
hypertonic saline solution”. Laryngoscope 107(4):500-3,
1997.
European Positioning Paper
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