Nasal irrigation during seasonal epidemics of influenza and acute respiratory viral infections

Abstract

Nasal irrigation is one of the most common recommendations for the treatment of patients with a wide variety of rhinologic diseases. First described in ancient Indian Ayurvedic papers, rinsing the nasal cavity with saline solutions remains relevant today with all the variety of available modern medications for local use. Nasal irrigation is a safe and effective method for the treatment and prevention of acute respiratory viral infections. The preventive use of nasal saline is especially important during the seasonal rise in the incidence of acute respiratory viral infections and influenza. Nasal irrigation reduces the viscosity of mucus and promotes its faster elimination along with pathogens fixed in it. Moreover, the use of isotonic saline solutions increases the effectiveness of the mucociliary clearance and reduces the concentration of local inflammatory mediators and cytokines. Acute upper respiratory tract infections, including common cold and acute rhinosinusitis, are common diseases that cause significant discomfort and are a common cause of temporary disability during periods of increased incidence of acute respiratory viral infections. Despite the fact that treatment of acute upper respiratory tract infections in most cases involves only symptomatic therapy the use of antipyretic drugs, sufficient fluid intake, local elimination and irrigation therapy is often used as adjuvant therapy in this group of patients. At the same time, it is quite difficult to assess the effectiveness of nasal lavage in clinical practice from the standpoint of evidence-based medicine. The purpose of this review is to analyze modern clinical studies and topical reviews assessing the effectiveness of nasal irrigation for various pathologies with a more detailed analysis of the effectiveness of this method for the treatment of patients with acute upper respiratory tract infections and as a preventive measure during the season of epidemic rise in the incidence of acute upper respiratory tract infections.