급성 부비동염 치료에서 saline irrigation

1. 진통제의 사용을 줄일 수 있고 전체적인 환자 편안암을 개선시킬 수 있습니다.

2. Saline irrigation 사용을 지지하는 증거는 제한적이지만, 부작용은 적고 증상 개선 가능성이 있습니다.

3. 소독하거나 생수를 사용해야 하며 수돗물로 세척한 경우 amebic encephalitis 케이스 보고가 있었습니다.

​

Mechanical irrigation with buffered, physiologic, or hypertonic saline may reduce the need for pain medication and improve overall patient comfort, particularly in patients with frequent sinus infections. The evidence supporting the use of saline irrigation is limited but indicates possible benefits for symptom relief with minor adverse effects, such as nasal burning and irritation. It is important that irrigants be prepared from sterile or bottled water as there have been reports of amebic encephalitis due to tap water rinses. Instructions for preparing a rinse solution are shown in the table.

​

How to perform nasal irrigation

Buffered normal saline nasal irrigation

The benefits

1. Saline (saltwater) washes the mucus and irritants from your nose.

2. The sinus passages are moisturized.

3. Studies have also shown that a nasal irrigation improves cell function (the cells that move the mucus work better).

The recipe

Use a one-quart glass jar that is thoroughly cleansed.

You may use a large medical syringe (30 cc), water pick with an irrigation tip (preferred method), squeeze bottle, or Neti pot. Do not use a baby bulb syringe. The syringe or pick should be sterilized frequently or replaced every two to three weeks to avoid contamination and infection.

Fill with water that has been distilled, previously boiled, or otherwise sterilized. Plain tap water is not recommended, because it is not necessarily sterile.

Add 1 to 1½ heaping teaspoons of pickling/canning salt. Do not use table salt, because it contains a large number of additives.

Add 1 teaspoon of baking soda (pure bicarbonate).

Mix ingredients together, and store at room temperature. Discard after one week.

You may also make up a solution from premixed packets that are commercially prepared specifically for nasal irrigation.

The instructions

Irrigate your nose with saline one to two times per day.

If you have been told to use nasal medication, you should always use your saline solution first. The nasal medication is much more effective when sprayed onto clean nasal membranes, and the spray will reach deeper into the nose.

Pour the amount of fluid you plan to use into a clean bowl. Do not put your used syringe back into the storage container, because it contaminates your solution.

You may warm the solution slightly in the microwave, but be sure that the solution is not hot.

Bend over the sink (some people do this in the shower), and squirt the solution into each side of your nose, aiming the stream toward the back of your head, not the top of your head. The solution should flow into one nostril and out of the other, but it will not harm you if you swallow a little.

Some people experience a little burning sensation the first few times that they use buffered saline solution, but this usually goes away after they adapt to it.

Adapted with permission from: Diseases of the Sinuses: Diagnosis and Management. Kennedy DW, Bolger WE, Zinreich SJ (Eds), BC Decker, Hamilton, Ontario 2001. Copyright © Kennedy DW, Zinreich SJ.

 

REF. UpToDate 2019.06.18