A historical review of the evolution of nasal lavage systems

Abstract

Background Nasal lavage is an ancient practice that still has a fundamental role in the management of sinonasal conditions. The history related to these devices is extensive and remarkable. By reviewing it, it is hoped that a broader view can be achieved on what is currently possible with nasal lavage and how advances may be made in the future. Methods A careful review of different sources, such as ancient manuscripts, registered patents and scientific papers, was conducted to achieve a thorough examination of the history related to nasal rinsing devices. Conclusion Nasal lavage has evolved significantly since first considered for medical use and has always played a central role in the treatment of patients with sinonasal conditions. Further innovation is still necessary to surmount the shortcomings of current nasal lavage systems.

Application of nasal irrigation in the treatment of chronic rhinosinusitis

“…Normal ciliary function plays an important role in maintaining a clean nasal cavity and sinuses. Irrigation improves ciliary activity and allows cilia to transport mucus, particles, and microorganisms efficiently [ 16 ].…”

“…Postoperative patients with CRS are routinely given biodegradable hemostatic sponges to stop bleeding, and when it degrades on its own, the residual hemostatic material and crusts will adhere to the operative cavity, thus delaying epithelialization of the operative cavity. Recent postsinus surgery flushing can effectively mechanically remove postoperative blood clots, degraded caulking material and crusts, and remove mucous snot, pathogens, and allergens from the nasal cavity to improve nasal mucosal cilia function, reduce inflammatory factor release, decrease nasal mucosal edema, unblock sinus drainage, promote sinus secretion drainage, facilitate surgical wound healing, and reduce the risk of postoperative adhesion [ 20 , 21 ]. The distant irrigation after sinusitis surgery makes it easier to clean the sinus cavity locally during irrigation and to distribute the irrigating drugs into the sinus cavity because the surgery enlarges the sinus opening and opens the sinuses.…”

The effect of nasal douching by hypertonic 2.3 per cent sea water with algae extracts on the concentration of epidermal growth factor, transforming growth factor-α and interleukin-8 in nasal secretions of patients with nasal polyposis following endoscopic surgical treatment

“…[1][2][3][4][5] Also, according to modern guidelines for the treatment of chronic rhinosinusitis, rinsing the nasal cavity with saline solutions is a mandatory part of the therapy, especially in the period after FESS. 1,2,6 Although the efficacy of FESS has been confirmed within the past three decades, delayed nasal mucosal healing and formation of adhesions following FESS, especially in the region of the middle nasal meatus, can be a potential cause of surgical failure, including blockage of mucociliary clearance and the recurrence of the sinus disease. 7 In the period after FESS, large areas of de-epithelialised nasal and/or paranasal sinus mucosa are left behind, and therefore it is necessary to ensure better epithelialisation of the mucosa and prevent the formation of granulations, fibrosis, crusts and adhesions in that sensitive period of two to three weeks.…”

“… 1 – 5 Also, according to modern guidelines for the treatment of chronic rhinosinusitis, rinsing the nasal cavity with saline solutions is a mandatory part of the therapy, especially in the period after FESS. 1 , 2 , 6 …”

Oddities in the Evolution of Syringes in Anesthesia

“…A lthough humanity has enjoyed the luxury of syringes since ancient times, it was the 19thcentury invention of the hypodermic needle that allowed us to inject medications into sites other than preexisting orifices to irrigate or evacuate natural or disease-made channels. [1][2][3] Syringes became a growing area of interest for doctors because the intravenous (IV) route produced more rapid and more precise clinical effects than oral administration. [4][5][6][7][8][9][10][11] Many doctors ordered their own "Named" (eg, Pravaz, Labat, and Pitkin) syringes, which were handmade by manufacturers in limited edition to each doctor's idiosyncratic specifications.…”