Development of an apparatus and procedure for evaluating the efficiency of nasal irrigation

Wu, Dawei; Chang, Feifan; Hong, Junsheng; Wei, Yongxiang

doi:10.1007/s00405-021-07249-8

Cited by 6 publications

(6 citation statements)

References 30 publications

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“…Recently, studies indicated that nasal irrigation with hypertonic saline could relieve COVID-19 symptoms such as nasal congestion and cough, and reduce the time of the 2019-nCoV clearance. 24,33 Our results showed that after treatment with nasal irrigation, the virus-negative time was reduced by an average of 5-6 days in children infected with Omicron; however, the duration of fever and cough did not improve. It has been reported that the adverse reactions of nasal irrigation, such as pain, nasal congestion and runny nose, worsen in response to an increase in saline concentration, partly due to the release of histamine and substance P. 33 Moreover, 3% hypertonic saline nasal irrigation was used to treat allergic rhinitis in children without significant adverse events.…”

Section: Discussionmentioning

confidence: 69%

“…24,33 Our results showed that after treatment with nasal irrigation, the virus-negative time was reduced by an average of 5-6 days in children infected with Omicron; however, the duration of fever and cough did not improve. It has been reported that the adverse reactions of nasal irrigation, such as pain, nasal congestion and runny nose, worsen in response to an increase in saline concentration, partly due to the release of histamine and substance P. 33 Moreover, 3% hypertonic saline nasal irrigation was used to treat allergic rhinitis in children without significant adverse events. 34 In this study, we found that 3% of hypertonic saline nasal irrigation had mild adverse reactions in the treatment of Omicron Note: Data were expressed as mean ± standard deviation.…”

Section: Discussionmentioning

confidence: 69%

“…32 Mucocilia in the nasal cavity can prevent various inhaled pathogens from entering the body. 33 A previous study suggested that the 2019-nCoV infection mainly invades the upper respiratory tract, and the virus titer in the nasal cavity is significantly higher than that in the throat. 33 Omicron variant infection can disrupt the ciliary epithelium, resulting in ciliary dyskinesia.…”

Section: Discussionmentioning

confidence: 98%

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Effect of Nasal Irrigation in Children With Omicron Variant of COVID-19 Infection

Liu,

Wang,

Xie

et al. 2023

Ear Nose Throat J

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Objective: To explore the effect of nasal irrigation on the disappearance of symptoms and nucleic acid conversion in children with Omicron variant. Methods: This quasi-experimental study included children diagnosed with asymptomatic, mild, and moderate Omicron variant infection during the isolation observation period in the Shandong Public Health Clinical Center between April 1, 2022 and May 1, 2022. The children were divided into a routine group (received Lianhua Qingwen (LhQw) Granules), isotonic saline group (received LhQw Granules combined with isotonic saline nasal irrigation), and hypertonic saline group (received LhQw Granules combined with 3% hypertonic saline nasal irrigation), respectively. The primary outcomes were the time of symptom disappearance and nucleic acid conversion time. The secondary outcomes were peripheral white blood cell count (WBC), lymphocyte count (LYM), neutrophil count (NEU), and C-reactive protein (CRP) levels. Results: A total of 60 children (7.26 ± 3.15 years old) were included (20 per group). The average time of nucleic acid conversion in the 2 saline nasal irrigation groups was significantly reduced compared with the routine group (all P < 0.001), while the fever time and cough duration among the 3 groups were comparable (all P > 0.05). LYM count in the 2 saline nasal irrigation groups was significantly increased after treatment compared to before treatment and was significantly higher than in the routine group (all P < 0.05). There was no significant difference in LYM count between the isotonic and hypertonic saline groups ( P = 0.76). Additionally, all children in the saline group well tolerated the treatment, and no adverse events occurred in the isotonic saline group. Conclusions: Timely use of saline nasal irrigation may promote nucleic acid conversion in children with Omicron virus infection.

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Section: Discussionmentioning

confidence: 69%

Section: Discussionmentioning

confidence: 69%

Section: Discussionmentioning

confidence: 98%

See 1 more Smart Citation

Effect of Nasal Irrigation in Children With Omicron Variant of COVID-19 Infection

Liu,

Wang,

Xie

et al. 2023

Ear Nose Throat J

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“…The connection between the nasal septum and the left sinonasal cavity was sealed with soft glue to maintain airtight except for the nostril and tracheal opening. A validated apparatus for fixing the 3D nose model has been developed in our previous study [ 26 ]. This platform was designed to provide coronal, sagittal, and horizontal planes, keeping the cast in a specific head position.…”

Section: Methodsmentioning

confidence: 99%

“…Three different volumes, including 120 ml, 175 ml, and 240 ml, were tested for each of the different head positions. We took the following three-step procedure to generate the irrigation efficiency [ 26 ]. The cast was tightly fixed in one of the six head positions.…”

Section: Methodsmentioning

confidence: 99%

A novel irrigation device with superior nasal irrigation efficiency to the classic rinse bottle

Chang

Hong

et al. 2022

Journal of Otolaryngology - Head & Neck Surgery

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Background The ability of saline irrigation to detach the mucous and the flow-limiting effect of the nasal valve has not been well explored. The objective of this study was to compare the removal efficiency of a novel irrigation device with an extended nozzle versus a classic rinse bottle. Methods Transparent casts of the unoperated sinonasal cavity were made by 3D printing. Yogurt was used to simulate mucous. The cast filled with 5 ml yogurt was fixed in six head positions and irrigated with 120 ml, 175 ml, and 240 ml dyed water through the novel device and the rinse bottle. The irrigation efficiency was the ratio of the weight of yogurt washed away divided by the total weight of yogurt. Results The irrigation stream of a long nozzle with a side opening was different from the irrigation stream of the outlet within the nasal vestibule. The novel devices presented with continuous water stream directly upwards to the anterior part of the olfactory cleft. Depending on different head positions, it was easy for the novel devices to achieve an irrigation efficiency of 100% when the cast was irrigated with 120 ml or 175 ml water. There was still a tiny amount of yogurt left in the olfactory cleft when the cast was irrigated with 240 ml water under each head position for the rinse bottle. The irrigation efficiency was volume-dependent, and the average irrigation efficiency of the rinse bottle at 240 ml only reached 69.1%. Conclusions The novel irrigation device presented with superior nasal irrigation efficiency to the classic rinse bottle. A continuous water stream directly upwards to the anterior part of the olfactory cleft combined with an extended nozzle overcoming the flow-limiting effect of the nasal valve promotes nasal irrigation efficiency. Graphical Abstract

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Optimizing Corticosteroid Sinonasal Irrigation Outcomes Through 3D Printing: A Randomized Pilot Clinical Trial

Root,

Lepley,

Kim

et al. 2024

OTO Open

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ObjectiveTopical corticosteroid irrigation plays critical role in the management of chronic rhinosinusitis (CRS). Yet, its efficacy can be highly variable. We sought to determine if personalized, 3‐dimensional (3D)‐printed nasal models can optimize head positioning and irrigation parameters, therefore improving patient outcomes.Study DesignRandomized, single‐blinded clinical trial.SettingTertiary medical center from November 2021 to July 2023.MethodsSixty‐two patients with CRS were randomized into either control (CG), backfill (BG), or model (MG) groups; daily 2 mg mometasone irrigations were then performed for 2 months with either standard head‐forward and natural side‐tilt position (CG), a head tilt of 90° to the side with fluid entering the lower nostril (BG), or in an optimized position as determined by a patient‐specific 3D printed irrigation model (MG), respectively.ResultsA total of 36 patients completed the trial (CG: N = 14/23; BG N = 11/23, MG: N = 11/16). Significant posttreatment improvement in Lund‐Mackay (LM) scoring was only observed in the MG (−3.73, 95% confidence interval = −5.71, −1.75; P < .001). Patient‐reported outcome measures (Nasal Obstruction Symptom Evaluation, Sinonasal Outcome Test‐22, and Visual Analog Scale of nasal congestion) improved significantly among all groups. Optimal model penetration scores significantly correlated to posttreatment MG LM score (Spearman's r = 0.65, P < .05). Among all groups, patients with prior endoscopic sinus surgery (ESS) (n = 19) had objectively less opacification at baseline; however, experienced the same degree of opacification reduction and symptom reduction as those without prior ESS (n = 17).ConclusionThe use of 3D printing to personalize head positioning may significantly improve objective corticosteroid irrigation outcomes. Mometasone irrigation may have similar subjective and objective effects on patients regardless of prior surgical history.Level of EvidenceLevel 1 prospective, randomized, single‐blinded clinical trial NCT06118554.

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Development of an apparatus and procedure for evaluating the efficiency of nasal irrigation

Cited by 6 publications

References 30 publications

Effect of Nasal Irrigation in Children With Omicron Variant of COVID-19 Infection

Effect of Nasal Irrigation in Children With Omicron Variant of COVID-19 Infection

A novel irrigation device with superior nasal irrigation efficiency to the classic rinse bottle

Optimizing Corticosteroid Sinonasal Irrigation Outcomes Through 3D Printing: A Randomized Pilot Clinical Trial

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