From the Research
For nasal saline irrigation using a device like a Neti pot, the recommended volume is typically 150 ml of saline solution per nostril, as supported by the most recent and highest quality study 1.
Recommended Approach
When performing nasal saline irrigation, it is essential to use a clean and safe water source to prevent infections. The solution should be isotonic or hypertonic saline, with a concentration of 0.9% sodium chloride or higher. To prepare the solution, mix 1/4 teaspoon of non-iodized salt with 8 ounces of distilled, sterile, or previously boiled and cooled water.
Key Considerations
- Always use clean, safe water to prevent infections 2, 3, 4, 5.
- Tilt your head sideways over a sink, breathe through your mouth, and pour the solution into the upper nostril, allowing it to drain from the lower nostril 2.
- Repeat on the other side.
- Nasal irrigation works by thinning mucus, removing irritants and allergens, and reducing inflammation in the nasal passages 1, 5.
- For sinusitis, irrigating 1-3 times daily is often beneficial, but you can adjust frequency based on your symptoms 3, 4.
- After each use, thoroughly clean and dry your irrigation device to prevent bacterial growth 2, 3, 4, 5.
Evidence-Based Recommendations
The most recent and highest quality study 1 suggests that large-volume (150 ml) hypertonic saline irrigation is beneficial for patients with chronic rhinosinusitis, with improved disease-specific health-related quality of life and patient-reported disease severity. However, the quality of the evidence is low, and further studies are needed to confirm these findings.
Safety and Efficacy
Nasal saline irrigation is generally safe, with minor adverse effects such as epistaxis and local irritation 1, 4. However, it is essential to use clean and safe water to prevent infections and to follow proper technique to minimize the risk of adverse effects.
Clinical Implications
Nasal saline irrigation is a useful adjunctive therapy for patients with chronic rhinosinusitis, and its use can be recommended as part of a comprehensive treatment plan. However, further studies are needed to determine the optimal volume, frequency, and duration of treatment, as well as the most effective type of saline solution and nasal device.