Scientific Endorsement

  • EPOS Primary Care Guidelines: European Position Paper on the Primary Care Diagnosis and Management of Rhinosinusitis and Nasal Polyps 2007 – a summary. Thomas M, Yawn BP, Price D, Lund V, Mullol J, Fokkens W; European Position Paper on Rhinosinusitis and Nasal Polyps Group. Prim Care Respir J.17:79-89. 2008 .
  • BSACI guidelines for the management of rhinosinusitis and nasal polyposis G. K. Scadding, S. R. Durham, R. Mirakian, N. S. Jones, A. B. Drake-Lee, D. Ryan, T. A. Dixon__, P. A. J. Huber and S. M. Nasser. Clinical and Experimental Allergy, 38 : 260–275, 2008
  • Nasal irrigation for chronic sinus symptoms in patients with allergic rhinitis, asthma, and nasal polyposis: a hypothesis generating study. Rabago D, Guerard E, Bukstein D. WMJ. 107(2):69-75. 2008
  • Nasal Saline Irrigations for the Symptoms of Chronic Rhinosinusitis. Harvey R, Hannan S, Badia L, Scadding G. Cochrane Database Syst Rev. 18:CD006394, 2007
  • Pediatric sinusitis. Tan R, Spector S. Curr Allergy Asthma Rep. 7:421-6, 2007
  • Qualitative Aspects of Nasal Irrigation Use by Patients with Chronic Sinus Disease in a Multimethod Study. Rabago D, Barrett B, Marchand L, Maberry R, Mundt M. Ann Fam Med. 4:295, 2006
  • Nasal irrigation in case of rhinosinusitis. Michel O. Laryngorhinootologie 85:448, 2006Evidence-based Recommendations for Antimicrobial Nasal Washes in Chronic
  • Rhinosinusitis. Elliott KA, Stringer SP. Am J Rhinol. 20:1, 2006
  • The Efficacy of Hypertonic Saline Nasal Irrigation for Chronic Sinonasal Symptoms. Rabago D, Pasic T, Zgierska A, Mundt M, Barrett B, Maberry R. Otolaryngol Head Neck Surg. 133:3, 2005
  • Chronic Sinusitis in Children. Steele RW. Clin Pediatr. 44:465, 2005:
  • Management for Optimal Outcomes. Aukema AA, Fokkens WJ. Treat Respir Med.3: 97, 2004Nasal Irrigations: Good or Bad? Brown CL, Graham SM. Curr Opin Otolaryngol Head Neck
  • Surg. 12:9, 2004
  • When Sinus Trouble Won’t Stay Away: for people with chronic sinusitis, nasal irrigation and surgery offer avenues for fewer relapses and better breathing. Metson R. Health News. 10:12, 2004
  • Nasal Irrigation as Adjunctive Care for Acute Sinusitis. Rabago D, Barrett B, Zgierska A. J Fam Pract. 53:137, 2004
  • Acute Bacterial Rhinosinusitis in Adults: part II. Treatment Scheid DC, Hamm RM. Am Fam Physician. 70:1697, 2004
  • Concomitant Chronic Sinusitis Treatment in Children with Mild Asthma: the effect on bronchial hyperresponsiveness. Tsao CH, Chen LC, Yeh KW, Huang JL. Chest 123:757, 2003
  • Saline Nasal Irrigation: Its role as an adjunct treatment. Papsin B, McTavish A. Can Fam Physician. 49:168, 2003
  • Efficacy of Daily Hypertonic Saline Nasal Irrigation Among Patients with Sinusitis: a randomized controlled trial. Rabago D, Zgierska A, Mundt M, Barrett B, Bobula J, Maberry R. J Fam Pract. 51:1049, 2002
  • Nasal Irrigation for the Alleviation of Sinonasal Symptoms. Heatley DG, McConnell KE, Kille TL, Leverson GE Otolaryngol Head Neck Surg 125:44, 2001
  • Management of Sinusitis: current clinical strategies. Kaliner M, Kennedy DW, en: Sinusitis Disease Management Guide. PDR 2000, 2000
  • Clinical Study and Literature Review of Nasal Irrigation. Tomooka LT, Murphy C, Davidson TM. Laryngoscope 110:1189, 2000
  • Effect of Irrigation of the Nose with Isotonic Salt Solution on Adult Patients with Chronic Paranasal Sinus Disease. Bachmann G, Hommel G, Michel O. European Archives of Otorhinolaryngology 257:537, 2000
  • Treatment of Sinusitis in the Next Millennium. Kaliner M. Allergy and Asthma Proceedings, 19:181, 1998
  • Sinusitis: Acute, Chronic and Manageable. Rachelevsky GS, Slavin RG. Patient Care 131:4, 1997
  • Efficacy of Sinus Irrigation Versus Sinus Irrigation Followed by Functional Endoscopic Sinus Surgery. Hartog B, van Benthem PP, Prins LC, Hordijk GJ Annals of Otology, Rhinology and Laryngology 106:759, 1997
  • Management of Sinusitis in Adult Cystic Fibrosis. Marks SC, Kissner DG. American Journal of Rhinology 11:11, 1997
  • Sinusitis: Bench to Bedside. Kaliner MA et al. Study group of sinusitis. Otolaryngology 116:6, 1997
  • Chronic Sinusitis. A Medical or Surgical Disease? Parson DS. En: Pedriatric Sinusitis.Otolaryngologic Clinics of North America 29:1, 1996
  • Sinus Survival. Ivker R. Putman Publication. 1995. Sinusitis: complications and sequelae. An Otolaryngologist’s Perspective. Fairbanks DNF.
  • Pediatric Infectious Diseases, 74:875, 1995
  • Management of Sinusitis in Cystic Fibrosis. Moss RB, King W. Archives of Otolaryngology Head Neck Surgery, 21:566, 1995
  • Management of Chronic Sinusitis in Cystic Fibrosis. Davidson T. Laryngoscope 105:354, 1995
  • Therapeutic Agents in the Medical Management of Sinusitis. Mabry RL. En: Inflammatory Diseases of the Sinuses. Otolaryngologic Clinics of North America 26:561, 1993
  • Pediatric Sinusitis. Manning SC. Otolaryngologic Clinics of North America 26:623, 1993Prospects for Ancillary Treatment of Sinusitis in the 1990s. Zeiger RS. Journal of Allergy and
  • Clinical Immunology, 90:478, 1994
  • Chronic rhinosinusitis: Epidemiology and medical Management. Daniel L. Hamilos. Clinical reviews in allergy and immunology, 693:707, 2011
  • Safety and efficacy of once-daily nasal irrigation for the treatment of pediatric chronic rhinosinusitis. Wei JL. Laryngoscope, 1989:2000, 2011
  • Nasal irrigation with or without drugs: the evidence. Nithin D. Adappa. Current Opinion, 1068:9508, 2012
  • Efficacy of nasal irrigation in the treatment of acute sinusitis in atopic children. Yun-Hu Wang. Journal of microbiology, Immunology and Infection, 1-7, 2012
  • Nasal Saline Irrigations for the Symptoms of Acute and Chronic Rhinosinusitis. Nils Achilles. Current Allergy Asthma Reports. 229:235, 2013
  • Efficacy of nasal irrigations and nebulizations for nasal symptom relief. Dunn JD. Curr Opin Otolaryngol Head Neck Surg,248:51, 2013
  • Clinical and Pathogenetic Characteristics of Pregnancy Rhinitis. Ellegard EK. Clin Rev
  • Allergy Immunol. 26:149, 2004
    Nasal Douching as a Valuable Adjunt in the Management of Chronic Rhinosinusitis.
  • Taccariello M, Parikh A, Darby Y, Scadding G. Rhinology 37:29, 1999
    Medical Management of Rhinitis. Fadal R. Otolaryngology, Gerald M English Ed. Vol 2:Ch 13,
  • 1996
    Atrophic Rhinitis. deSouza FM. Otolaryngology, Gerald M English Ed., Ch14, 1996
  • Rinitis Alérgica y no Alérgica. Meltzer EO et al. En: Alergia: principios y práctica. Middleton E, Reed Ch, Ellis EF, Adkinson NF, Yunginger JW, eds., vol 2, Salvat, 1181, 1992
  • Rhinitis and Nasal Obstruction. Lucente FE. En: Nasal Obstruction. Otolaryngologic Clinics of North America 22:307, 1989
  • Atrophic Rhinitis. Goodman. Otolaryngology, Gerald M English Ed. Vol 2, Ch. 14, 1984Chronic Rhinitis, a Practical Approach to Diagnosis and Treatment. Zeigler R, Shatz M.
  • Immunology and Allergy Practice 4:2, 1982
  • Chronic rhinosinusitis: Epidemiology and medical Management. Daniel L. Hamilos. Clinical reviews in allergy and immunology, 693:707, 2011
  • Nasal irrigation with or without drugs: the evidence. Nithin D. Adappa. Current Opinion, 1068:9508, 2012
  • Efficacy of nasal irrigation in the treatment of acute sinusitis in atopic children. Yun-Hu Wang. Journal of microbiology, Immunology and Infection, 1-7, 2012
  • Nasal Saline Irrigations for the Symptoms of Acute and Chronic Rhinosinusitis. Nils Achilles. Current Allergy Asthma Reports. 229:235, 2013
  • Efficacy of nasal irrigations and nebulizations for nasal symptom relief. Dunn JD. Curr Opin Otolaryngol Head Neck Surg,248:51, 2013
  • Nasal saline irrigation facilitates control of allergic rhinitis by topical steroid in children. Li H, Sha Q, Zuo K, Jiang H, Cheng L, Shi J, Xu G. ORL J Otorhinolaryngol Relat Spec.71:50-5, 2009
  • Nasal Rinsing with Hypertonic Solution: an Adjunctive Treatment for Pediatric Seasonal Allergic Rhinoconjunctivitis. Garavello W, Di Berardino F, Romagnoli M, Sambataro G, Gaini RM. Int Arch Allergy Immunol. 137:310, 2005
  • Is Hypertonic Saline Better than Normal Saline for Allergic Rhinitis in Children?
  • Degirmencioglu H, Karadag A, Avci Z, Kurtaran H, Catal F. Pediatr Allergy Immunol. 15:190, 2004Nasal Saline for Allergic Rhinitis: an Alternative Treatment Method. Yilmaz T, Kurtaran H,
  • Karadag A, Uras N. Acta Otolaryngol. 124:1240, 2004
  • Hypersaline Nasal Irrigation in Children with Symptomatic Seasonal Allergic Rhinitis: a Randomized Study. Garavello W, Romagnoli M, Sordo L, Gaini RM, Di Berardino C, Angrisano A. Pediatr Allergy Immunol. 14:140, 2003
  • Inhibition of the Seasonal IgE Increase to Dactylis glomerata by Daily Sodium Chloride Nasal-sinus Irrigation During the Grass Pollen Season. Subiza JL, Subiza J, Barjau MC, Rodríguez R, Gavilán MJ. Journal of Allergy and Clinical Immunology, 104:711, 1999
  • Pathophysiology and Treatment of Allergic Sinusitis. Kaliner, M.A. En: Current Review of Allergic Diseases, Michael A. Kaliner (ed.), Current Medicine, p.125, 1998
  • Nasal Hyperthermia and Simple Irrigation for Perennial Rhinitis. Changes in Inflammatory Mediators. Georgitis JW. Chest, 106:1487, 1994
  • Efficacy of nasal irrigation in the treatment of acute sinusitis in atopic children. Yun-Hu Wang. Journal of microbiology, Immunology and Infection, 1-7, 2012
  • Nasal irrigation as an adjunctive treatment in allergic rhinitis: a systematic review and meta-analysis. Hermelingmeier KE. Am J Rhinol Allergy, 119:25, 2012.
  • Hypertonic saline is more effective than normal saline in seasonal allergic rhinitis in children. Marchisio P. Int J Immunopathol Pharmacol, 721:30, 2012.
  • Efficacy of buffered hypertonic saline nasal irrigation in children with symptomatic allergic rhinitis: a randomized double-blind study. Satdhabudha A. Int J Pediatr Otorhinolaryngol, 583:8, 2012
  • Tap water nasal irrigation in adults with seasonal allergic rhinitis: a randomized double- blind study. Min Xiong. Eur Arch Otorhinolaryngol, 2741:4, 2013.
  • Impact of isotonic and hypertonic saline solutions on mucociliary activity in various nasal pathologies: clinical study. Ural A, Oktemer TK, Kizil Y, Ileri F, Uslu S. Laryngol Otol. 28:1-5, 2008
  • Ringer-Lactate Solution Versus Isotonic Saline Solution on Mucociliary Function after Nasal Septal Surgery. Unal M, Gorur K, Ozcan C. J Laryngol Otol. 115:796, 2001
  • Mucociliary Clearance and Buffered Hypertonic Saline Solution. Talbot A, et alLaryngoscope 107:500, 1997
  • Enhancing the Mucociliary System. Grossan M. Advances for Respiratory Care Practitioners, 8:12, 1995
  • Office Measurement of Nasal Mucociliary Clearance. Grossan M. Otolaryngology, Gerald M English Ed. Vol 2, Ch 7, 1994
  • Effect of Amiloride and Saline on Nasal Mucociliary Clearance and Potential Difference in Cystic Fibrosis and Normal Subjects. Middelton PG, Geddes DM, Alton EW. Thorax 48:812, 1993
  • Mucociliary Flow in Otolaryngology Practice. Grossan M. Insights in Otolaryngology, 8:2, 1993
  • Ciliary Beating Frequency in Chronic Sinusitis. Nuutinen J. Archives of Otolaryngology Head Neck Surgery, 119:645, 1993
  • A Device to Aid Nasal Mucociliary Flow. Grossan M. A.N.L. 3:65,1976
    The Saccharin Test of Nasal Mucociliary Function. Grossan M. Eye, Ear, Nose and Throat
  • Monthly, 54:415, 1975
  • The impact of hypertonic saline inhalation on mucociliary clearance and nasal nitric oxide. A. Bencova. Journal of physiology and pharmacology, 309:313, 2012
  • A preliminary randomised controlled trial evaluating the efficacy of saline douching following endoscopic sinus surgery. Freeman SR, Sivayoham ES, Jepson K, de Carpentier J.Clin Otolaryngol. 33:462-5, 2008
  • Effects of endoscopic sinus surgery and delivery device on cadaver sinus irrigation.
  • Harvey RJ, Goddard JC, Wise SK, Schlosser RJ. Otolaryngol Head Neck Surg.139:137-42, 2008
  • Effects of buffered 2.3%, buffered 0.9%, and non-buffered 0.9% irrigation solutions on nasal mucosa after septoplasty. Süslü N, Bajin MD, Süslü AE, Oğretmenoğlu O. Eur Arch Otorhinolaryngol. 2008
  • Evaluación de Métodos de Irrigación Nasosinusal en Postoperatorio de C.E.N.S. Cenjor C, Gutiérrez R, Sanabria J, Márquez F, Martínez D, Pastormeloc G. Actas del XVII Congreso de la Sociedad Española de Otorrinolaringología y Patología Cérvico facial, Las Palmas de Gran canaria, 12-16 Octubre, 1998
  • Perioperative Care in Functional Endoscopic Sinus Surgery. Sonkens JW, Miller RJ,Highlights of The Instructional Courses. Lucente Ed. Ch 24, 267, 1997.
  • Management of sinusitis in cystic fibrosis by endoscopic surgery and serial antimicrobial lavage. Reduction in recurrence requiring surgery. Moss RB, King VV. Arch Otolaryngol Head Neck Surg 121:566, 1995
  • Endoscopic Paranasal Sinus Surgery. Rice D. Ravens Press, 1993.
    Surgical approach to tumors of the nasal cavity. Pope TH Jr. Laryngoscope 88: 1743, 1978
  • The impact of intraoperative saline irrigations on bacterial load within the maxillary sinus. Seiberling KA. Int Forum Allergy Rhinol, 351:5, 2011
  • Role of Medical Therapy in the Management of Nasal Polyps. Isma Alobid. Curr Allergy Asthma Rep, 144:153, 2012
  • Single-blind randomized controlled trial of surfactant vs hypertonic saline irrigation following endoscopic endonasal surgery. Farag AA. Int Forum Allergy Rhinol, 276:80, 2013.
  • A prospective randomized single-blinded clinical trial comparing the efficacy andtolerability of the nasal douching products SterimarTM and Sinus RinseTM following functional endoscopic sinus surgery. Salib RJ. Clin Otolaryngo, 297:305, 2013.
  • Does nasal irrigation enter paranasal sinuses in chronic rhinosinusitis? Snidvongs K,
  • Chaowanapanja P, Aeumjaturapat S, Chusakul S, Praweswararat P Am J Rhinol. 22:483-6, 2008
  • Nasal saline for chronic sinonasal symptoms: a randomized controlled trial. Pynnonen MA, Mukerji SS, Kim HM, Adams ME, Terrell JE. Arch Otolaryngol Head Neck Surg. 133:1115-20 2007
  • Nebulized bacitracin/colimycin: a treatment option in recalcitrant chronic rhinosinusitis with Staphylococcus aureus? A double-blind, randomized, placebo-controlled, cross-over pilot study. Videler WJ, van Drunen CM, Reitsma JB, Fokkens WJ. Rhinology.46:92-8, 2008
  • A comparative Study of Three Methods of Nasal Irrigation. Wormald PJ, Cain T, Oates L, Hawke L, Wong I. Laryngoscope 114:2224, 2004

Radiographic Comparison of Three Methods for Nasal Saline Irrigation. Olson DE, Rasgon BM, Hilsinger RL Jr. Laryngoscope. 112:1394, 2000

Decontaminating the Nasal Passages. Berger ME, Jones OW, Ricks RC, Garrett S. Health Phys. 84(5 Suppl):S80, 2003

Comparison of nasal sprays and irrigations in the delivery of topical agents to the olfactory mucosa. Lam K. Laryngoscope, 2013

  • Reglamento de la Unión Europea no: 1129/2011. Diario oficial de la UE. Noviembre de 2011
  • Guía para la aplicación de la legislación de aditivos y contaminantes de la UE en productos pesqueros y acuícolas. Ministerio de Agricultura, Alimentación y Medio Ambiente. Madrid, 2012
  • Ministerio de Sanidad, Política Social e Igualdad, BOE no 219 de Septiembre de 2011 sobre la lucha contra el dopaje en el Deport.
  • Effect of Xylitol on Growth of Nasopharyngeal Bacteria In Vitro. TERO KONTIOKARI.ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 1820:1823, 1995.
  • Antiadhesive effects of xylitol on otopathogenic bacteria. Tero Kontiokari. Journal of Antimicrobial Chemotherapy, 563:565, 1998.
  • Xylitol Nasal Irrigation in the Management of Chronic Rhinosinusitis. Joshua D. Department of Otolaryngology – Head and Neck Surgery Stanford University School of Medicine
  • The osmolyte xylitol reduces the salt concentration of airway surface liquid and may enhance bacterial killing. Joseph Zabner. Proceedings of the National Academy of Sciences of
  • Xylitol in preventing acute otitis media. Matti Uhari. Vaccine, 144:147, 2001.
    Xylitol enhances bacterial killing in the rabbit maxillary sinus. Brown CL, Laryngoscope,
  • 2021:4, 2004
  • In vitro susceptibility of established biofilms composed of a clinical wound isolate of Pseudomonas aeruginosa treated with lactoferrin and xylitol Mary Cloud B. Ammons.International Journal of Antimicrobial Agents, 230:236, 2009
  • Xylitol nasal irrigation in the management of chronic rhinosinusitis: a pilot study.
  • Weissman JD. Laryngoscope, 2468:72, 2011
    European position paper on rhinosinusitis and nasal polyps. Official journal of the European
  • and International Societies. 2012
  • Efficacy of nasal irrigations and nebulizations for nasal symptom relief. Dunn JD. Curr Opin Otolaryngol Head Neck Surg,248:51, 2013
  • Topical antimicrobials in the management of chronic rhinosinusitis: a systematic review.
  • Lim M, Citardi MJ, Leong JL. Am J Rhinol.22 (4):381-9,2008
    Nasal lavage with mupirocin for the treatment of surgically recalcitrant chronic
  • rhinosinusitis. Uren B, Psaltis A, Wormald PJ. Laryngoscope. 118:1677-80, 2008
  • Nebulized bacitracin/colimycin: a treatment option in recalcitrant chronic rhinosinusitis with Staphylococcus aureus? A double-blind, randomized, placebo-controlled, cross-over pilot study. Videler WJ, van Drunen CM, Reitsma JB, Fokkens WJ. Rhinology.46:92-8, 2008
  • Nasal irrigation reduces postirradiation rhinosinusitis in patients with nasopharyngeal carcinoma. Liang KL, Kao TC, Lin JC, Tseng HC, Su MC, Hsin CH, Shiao JY, Jiang RS. Am J Rhinol. 22:258-62, 2008
  • Evidence-based Recommendations for Antimicrobial Nasal Washes in Chronic Rhinosinusitis. Elliott KA, Stringer SP. Am J Rhinol. 20:1, 2006
  • Non-invasive Treatment of Intractable Posterior Epistaxis with Hot-water Irrigation. Schlegel-Wagner C, Siekmann U, Linder T.Rhinology. 44:90, 2006
  • New Modification of Hot-water Irrigation in the Treatment of Posterior Epistaxis. Stangerup SE, Dommerby H, Siim C, Kemp L, Stage J. Arch Otolaryngol Head Neck Surg 125:686, 1999
  • Rhinovirus Infection Induces Mucus Hypersecretion. Yuta A, Doyle WJ, Gaumond E, Ali M, Tamarkin L, Baraniuk JN, Van Deusen M, Cohen S, Skoner DP. Am J Physiol 274:1017, 1998
  • Effect of Nasal Lavage on Nasal Symptoms and Physiology in Wood Industry Workers. Holmstrom M, Rosen G, Wahlander L. Rhinology 35:108, 1997
  • Nasal saline irrigation in children: a study of compliance and tolerance. Jeffe JS. Int J Pediatr Otorhinolaryngol, 409:13, 2012

Clinical trials

There are numerous clinical studies that show how a daily nasal irrigation improves the symptoms and the life quality of people suffering nasal obstruction, chronic sinusitis, excessive mucus and nasal allergies.

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