Otolaryngology Book

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Nasal Saline

Aka: Nasal Saline, Saline Nasal Spray, Neti Pot
  1. See Also
    1. Topical Decongestants
  2. Precautions
    1. Use pre-prepared solution or filtered, distilled or boiled water (after allowing to cool)
      1. Non-sterilized tap water rinses have been associated with amebic Encephalitis
      2. Yoder (2012) Clin Infect Dis 55(9): e79-85 [PubMed]
  3. Preparations: Commercial
    1. Saline Nasal Spray (SeaMist, Ocean, Deep Sea)
  4. Preparations: Quick Homemade Recipe
    1. Mix 1/2 tsp non-iodized salt in 8oz warm water
    2. Store in empty spray bottle
    3. Make new solution after 2 days
  5. Preparations: Standard Homemade Recipe
    1. Recipe Ingredients
      1. 1 qt glass jar
      2. 1 qt boiled tap or bottled water
      3. 2 to 3 heaping teaspoons non-iodized salt (Iodine may interfere with cilia function)
      4. 1 rounded teaspoon baking soda
    2. Recipe Preparation
      1. Wash, rinse and fill jar with boiled water
      2. Add Table Salt and Baking Soda
      3. Stir or shake before each use
      4. Store in refrigerator and mix fresh batch weekly
    3. Recipe Modifications
      1. If the mixture is too strong, reduce salt to 1-2 tsp
      2. If your nose is dry, add 1 tbsp corn syrup to mix
  6. Technique: Directions for Adults
    1. Bulbs to Instill Mixture
      1. Bulb
      2. Ear Syringe
      3. Medical Syringe
      4. Waterpik
    2. Rinse the nose with the solution 2-3 times daily
    3. Avoid contaminating stock solution
      1. Pour mixture into clean bowl
      2. Do not place syringe back into original solution
    4. You may warm the mixture to Body Temperature (Not hot!)
    5. Stand over the sink or shower; squirt into each nostril
    6. Aim the stream toward the back of the nose
    7. Use prior to Intranasal Steroid
  7. Technique: Directions for children
    1. Older children (who can blow nose)
      1. Instill 3 drops in each nostril while supine prn
      2. Wait 1 minute, while softens mucus, then blow
    2. Younger children
      1. Instill 3 drops each nostril while supine prn
      2. Wait 1 minute, then use suction bulb
      3. Seal nares completely with bulb to suction
  8. Technique: Neti Pot
    1. Prepare Saline Solution as above or use pre-prepared saline packets
    2. Position nose by tilting head forward and to one side
    3. Tilt Neti Pot up and seal to one nostril
    4. Saline should pour into one nostril and flow out of the other
  9. Adverse effects
    1. Mild burning sensation with first few uses
    2. Resolves with first few uses
    3. Amebic Encephalitis (rare, associated with contaminated tap water use)
      1. See Precautions above (only use filtered, distilled or boiled water)
  10. Reference
    1. Ferguson (1997) J Postgrad Med 101(5): 117-131 [PubMed]

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