Therapeutic
Agents In The Medical Management Of Sinusitis, Mabry,
R.L. In: Inflammatory diseases of the sinuses. Otolaryngologic
Clinics Of North America, Volume 26, Number 4, pp 561, 1993.
Not only is the Grossan Sinus Irrigator beneficial for patients
with bothersome thick postnasal secretions, but is especially
helpful for postoperative cleansing following nasal surgery.
Sinusitis:
Acute, Chronic and Manageable, Rachelevsky G S, Slavin R G et
all. Patient Care. Feb 28, 1997 Vol 131:4. "A particularly helpful
strategy is saline washing using a a Water Pik Sinus irrigator
is so effective in clearing the blocked passages that , if it
is done regularly, some patients with persistent or chronic
sinusitis need no drug treatment at all.
A Device
for sinus treatment Grossan M Transactions of the American Academy
of Ophthalmology and Otolaryngology. 78: July 1974 279-280 An
easy method of sinus treatment at home or office. With this
device the patient can leave the office with the bacterial load
reduced, hence requires less antibiotic and much greater patient
satisfaction.
Sinusitis:
Bench to Bedside, Kaliner MA et al. Otolaryngology June
97 116:6 Part 2 Study of Sinusitis. Water Pik pulsatile sinus
irrigation is recommended as a treatment for sinusitis, and
as a supplement to other treatment modalities.
A New Nasal
Irrigator Device. Grossan M. The Eye, Ear Nose And Throat Monthly.
March 1974 Application of Pulsatile irrigation for post nasal
drip and phlegm
A Device
To Aid Nasal Mucociliary Flow, Grossan A.N.L. March 1976 pp
65-70. In Japan there is a very high incidence of sinusitis
requiring surgery. Pulsatile irrigation is helpful to avoid
surgery.
Office
Measurement of Nasal Mucociliary Clearance, Grossan, M.
English: Otolaryngology 1994 Vol 2 ch 7 The saccharin test is
an objective measure of one very important aspect of the respiratory
defense system. Many diagnostic dilemmas are solved using this
test. The nasal test reflects the chest condition. Using Pulsatile
irrigation, one can improve both.
Treatment
of Sinusitis in the Next Millennium, Kaliner, M. Allergy
and Asthma Proceedings, 19:181-4, 1998 Saline irrigation with
Water Pik and sinus adaptor is an effective non-drug treatment
for sinusitis
Nasal
Hypothermia and Simple Saline Irrigation for Perennial Rhinitis,
Changes in Inflammatory Mediators, Georgitis JW. Chest 106:1487
- 82, 1994 Saline irrigation with Water Pik and Grossan adaptor
reduces significantly the presence of mediatiores of inflammation
in the nasal exudates six hours after treatment.
Sinus
Survival, Ivker R., Putman Publication 1995. Pulsating irrigation
is shown to remove pus and allow for natural, holistic healing.
A Device
for Nasal Irrigation, Grossan, M. Transactions of the American
Academy of Ophthalmology and Otolaryngology. 78: July 1974 279-280.
Nasal irrigation is found to be an easy method of sinus treatment
at home or office. With this device the patient can leave the
office with the bacterial load reduced, hence requiring less
antibiotic and producing greater patient satisfaction.
Pulsation
Irrigation: a Simple, Safe Effective Treatment of Many Nasal
Complaints, Pope, A., O.R.L. Digest August 1974 15:8 pp 3638.
Pulsatile nasal irrigation is recommended as a simple safe treatment
for many sinus, ear and allergy complaints. High patient acceptance
and enthusiasm is reported.
A
New Nasal Irrigator Device, Grossan, M., The Eye, Ear Nose and
Throat Monthly, March 1974. Application of Pulsatile irrigation
for post nasal drip and phlegm is described.
Pulsatile
Nasal Irrigation in Children
Pediatric
sinusitis, Manning, Scott, C., In: Inflammatory Diseases
of the Sinuses. Otolaryngologic Clinics of North America. Volume
26, Number 4, pp 623-638 (1993). Pulsatile irrigation works
for children, even without antibiotics.
Irrigation
of the Child's Nose, Grossan, M., Clinical Pediatrics, March
1974 13:3 229-231. Children with sinusitis, post nasal drip
or nasal blockage use pulsatile nasal irrigation at age 5 or
older. By removing discharge, adenoid and tonsil hypertrophy
were reduced. Irrigation was also found to be an aid to clearing
the ear.
Rhinitis
Rhinitis
And Nasal Obstruction, Lucente, F.E. In: Nasal Obstruction.
Otolaryngologic Clinics Of North America, Volume 22, Number
2, pp 307, 1989. The Water Pik® irrigation device with the Grossan
nasal irrigator tip is an efficient system for irrigation .
The irrigate is instilled as a pulsating stream into one nasal
cavity and drains out through the other side. The Grossan nasal
irrigator effectively loosens crusts.
Atrophic
Rhinitis, Goodman, Wilfred S. English: Otolaryngology Vol
2 Ch. 14 1984 Atrophic rhinitis varies in severity and is difficult
to cure. Dr Goodman recommends Pulsatile irrigation for symptomatic
relief and treatment.
Medical
Management of Rhinitis, Fadal R. English: Otolaryngology
Vol 2:Ch 13 The principal benefits from saline irrigation include:
-
Augments mucociliary
flow
-
Liquefies tenacious
mucus
-
Soothes irritated
tissues
-
Removes crusts and
micro foreign bodies
-
Augments tissue
repair
-
Reduces forceful
nose blowing
-
Improves olfaction.
Chronic
Rhinitis, a Practical Approach to Diagnosis And Treatment,
Zeigler, R. Shatz , M Part 2 Treatment. Immunology, Allergy
Practice 1982. 4:3 pp 26-36 Good allergy management includes
use of irrigation for removal of offending particles and restoring
normal ciliary's flow.
Allergic
or Non Allergic Rhinitis, Meltzer EO, In Allergy: Principles
and Practice, editors: Middleton and Reed. Vol 2 pp 1181, 1992
It has been shown in many patients with chronic rhinitis that
mucociliary transport is markedly increased after two weeks
of one or two times a day irrigation using the Water Pik with
the Grossan attachment.
Rhinitis,
Allergy: Principles and Practice, 3rd edition. Middleton
E. CV Mosby Company Ch 17, 1988 All forms of allergy rhinitis
are benefited by saline irrigation with the Water Pik and nasal
attachment.
Medical
Management of Rhinitis, Fadal R. English: Otolaryngology
1996, Vol 2:Ch 13. The principal benefits from saline irrigation
are shown to include: 1. Augments mucociliary flow 2 Liquefies
tenacious mucus 3. Soothes irritated tissues 4. Removes crusts
and micro foreign bodies 5. Augments tissue repair 6. Reduces
forceful nose blowing 7. Improves olfaction.
Atrophic
Rhinitis, deSouza, F.M.: Chapter 14N English: Otolaryngology
1996. The Water Pik dental irrigation device with the Grossan
nasal irrigator tip is shown to increase the efficiency of saline
nasal douches.
Atrophic
Rhinitis, Goodman, Wilfred S., Otolaryngology Vol 2 Ch.
14 1984. Atrophic rhinitis varies in severity and is difficult
to cure. Pulsatile irrigation is recommended for symptomatic
relief and treatment.
Chronic
Rhinitis, a Practical Approach to Diagnosis and Treatment,
Zeigler, R. Shatz , M Part 2 Treatment. Immunology, Allergy
Practice 1982. 4:3 pp 26-36. Good allergy management is shown
to include irrigation for removal of offending particles in
order to restore normal ciliary flow.
Atrophic
Rhinitis, deSouza F.M.: Chapter 14N, English: Otolaryngology
1996. "The Water Pik dental irrigation device with the Grossan
nasal irrigator tip has increased the efficiency of saline nasal
douches."
Asthma
Sinusitis
and Bronchial Asthma, Slavin RG: J Allergy and Clinical
Immunol 66:250-257, 1980 Slavin presents three mechanisms re
sinusitis causing asthma. Clearing sinusitis is important in
asthma.
Allergy
Inhibition
Of The Seasonal Ige Encrease To Dactylis Glomerata By Daily
Saline Nasal - Sinus Irrigation During The Grass Pollen Season,
Journal of Allergy and Clinical Immunology. In press Pulsatile
irrigation works for allergy by removing the IgE so that the
pollen doesn't cause symptoms.
Post-Operative
Care
Perioperative
Care in Functional Endoscopic Sinus Surgery, Sonkens JW,
Miller R.J. Highlights of the Instructional Course. Ed Lucente,
editor Chapter 24. pp267-277 Pulsatile irrigation should be
done 1 to 3 times a day postoperatively until no further benefit
is achieved.
Endoscopic
Paranasal Sinus Surgery, Rice, D., Ravens Press 1993. Pulsatile
irrigation before sinus surgery is recommended to reduce infection
and after surgery to restore ciliary function and reduce patient's
symptoms.
Cystic Fibrosis
Management
Of Sinusitis In Cystic Fibrosis, Moss RB, King W. . Arch
Otolaryngol Head Neck Surg. 1995;1 21:566-572. Stresses the
use of water pik irrigator with nasal adaptor for home use.
Recommends antibiotic irrigation of sinuses.
Water Pik
Irrigation with Grossan Adaptor is used for CF, Cystic Fibrosis
Currents Volume 11, No 4
Method
For Rapid Evaluation Of Topical Of Topically Applied Agents
To Cystic Fibrosis, Wine JJ, King W, Lewiston NJ Am J Physiol.
1991261 (Lung Cell Mol Physiol. 5):L21 8-L221 Water Pik sinus
irrigation makes an ideal vehicle for local administration of
antibiotics and other products.
Management
of Chronic Sinusitis in Cystic Fibrosis, Davidson, T., Laryngoscope
105:354 April 1995. Cystic fibrosis is commonly associated with
sinusitis due to mucociliary system failure. Patients may benefit
by lung transplant. Pre-op pulsatile saline irrigation is found
to be a successful means of clearing the sinus of disease.
More
Laboratory-Oriented Topics
Ciliary Function
& Mucociliary Clearance
Mucociliary
Clearance and Buffered Hyper tonic Saline Solution, Talbot
A, et al Laryngoscope 107:April 1997 Stresses the importance
of saline irrigation for Mucociliary Clearance for patients
with acute and chronic sinusitis, and post operative functional
endoscopic sinus surgery. Finds close correlation with the saccharin
test to other methods of measurement.
Enhancing
The Mucociliary System, Grossan, M. Advances for respiratory
care practitioners.. April 17, 1995 8 pp12-13 Coughing, wheezing,
respiratory complaints may be significantly benefited by use
of the Pulsatile saline irrigator. Removing pus from the sinus
via simple irrigation can significantly speed healing and prevent
spread of infection from the sinus to the lungs. Daily removal
of pus by the patient at home is beneficial.
Sinusitis:
Complications And Sequelae: An Otolaryngologist's Perspective,
Fairbanks, D.N.F.: Pediatr Infect Dis J 4 (Suppl 6) 875-878
1995 Shows that radiographic material placed in the nose before
bedtime is found in the tracheobronchial tree in the morning.
Thus sinus secretions can contaminate the tracheobronchial tree
causing infection and bronchospasm. Hence the value of irrigation
to remove offending material.
Evaluation
of methods of Sinus Nasal Irrigation Irrigation Post Sinus Surgery,
Cenjor, C. Gutierrez, R. Congress of Spanish Society of Otolaryngology
and Cervical Facial Pathology. Las Palmas de Gran canaria, 12-
16 Octubre de 1998 Water pik irrigation with Grossan sinus adaptor
is the preferred method of treatment after endoscopic surgery.
Highly accepted by patients.
Office
Measurement of Nasal Mucociliary Clearance, Grossan, M.,
English: Otolaryngology 1994 Vol 2 ch 7. The saccharin test
is shown to be an objective measure of one very important aspect
of the respiratory defense system. Many diagnostic dilemmas
are solved using this test. The nasal test reflects the chest
condition. Using pulsatile irrigation, one can therefore improve
both chest and sinus problems.
Ciliary
Beating Frequency in Chronic Sinusitis, Nuutinen J, Arch
Otolaryngol Head Neck Surg 119:645, 1993. After diseased mucosa
is cleared of thick mucus and bacteria, ciliary function is
shown to return.
Mucociliary
Flow in Otolaryngology Practice, Grossan M., Insights in
Otolaryngology. August 1993 8 :2-8. Many noxious exposures can
inactivate mucociliary clearance, including smog, exhaust fumes,
chlorine, chromium, etc. The sooner normal ciliary activity
is restored, the sooner the natural physiology of the defense
system can ward off illness. Hot tea, chicken soup, iodides,
and pulsatile irrigation are shown to be important aids to the
natural defense system.
The Saccharin
Test of Nasal Mucociliary Function, Grossan, M., Eye, Ear,
Nose and Throat Monthly 1975 54:(11), pp 415-417. An objective
test of mucociliary clearance is described. This test is useful
for measuring cilia function before and after Pulsatile nasal
irrigation to objectify degree of improvement.
Nasal
Mucociliary Flow - A Clinical View, Grossan, M., Amer Acad
of Otol and Ophth Scientific Presentation Dallas 1975 (certificate
of merit award). How to effect improvement of mucociliary clearance.
Irrigation Fluid
& Salinity
Physiologic
and Hypertonic Saline Solutions Impair Ciliary Activity in Vitro,
Boeck,Wilbert. Keles, Nesil. Graamans, Kees, Laryngoscope March
99 No 3, p.396. Certain hypertonic saline solutions cause ciliostasis
(the cilia stop functioning) from which the cilia may not recover.
If cilia are permanently damaged, the ability to fight infection
is lost.
Pulsatile
Action
Using
Pulsatile Pressure Saline/Antibiotic Irrigation, Betts N.
et al. Compendium Contin Educa Dent, 17(9): 871 1996. The efficacy
of Pulsatile saline irrigation has been demonstrated in orthopedics,
surgery and dental literature too.
Evaluation
Of Wound Irrigation By Pulsatile Jet And Conventional Methods,
Brown LL; Shelton HT. Ann Surg. 1978 Feb, 187:2, 170-3 Comparison
with Pulsatile irrigation versus bulb syringe - only Pulsatile
irrigation about significant reduction of bacteria. Conclusion:
Pulsatile irrigation removed bacteria from experimental wounds
more efficiently than conventional procedures.
The Efficacy
of Various Irrigation Solutions in Removing Slime Producing
Staphylococcus, Anglen, J. J., Orthop Trauma 1994 Oct;8(5):390-6.
In an orthopedic research project, it is shown that Pulsatile
irrigation is 100x more effective in removing bacteria from
a site than simple irrigation, and is even more effective than
some antibiotic solutions in tests for clearing infection.
Pulsatile Irrigation
of the Throat
A Mechanical
Throat Irrigator, Grossan, M., Transactions of the American
Academy of Ophthalmology and Otolaryngology. 77: January 1973.
Throat irrigation is shown to significantly reduce the need
for antibiotics, and to possibly reverse the need for tonsillectomy.
It is also shown to be specially valuable to prevent the spread
of infection within the family.
An Instrument
for Throat Irrigation, Grossan, M., The O.R.L. Digest July
1972 39:7 pp10-13. A method to replace gargling is presented
that is safe and pleasant. Gargling may cause laryngitis and
has been shown to be ineffective.
Irrigation
Treatment of Throat Infections, Grossan, M, The Eye, Ear,
Nose and Throat Monthly. August 1972 51:8 pp302-305. Irrigation
of the throat is shown to bring blood to the area, encourage
lymphatic drainage, and remove bacteria on the surface and in
the crypts.
Pulsatile Irrigation
For the Ears
A New
Ear Irrigator, Grossan, M.: Arch. Otorhinolaryngology 1978
86(6):936-937. A new design for a Pulsatile ear irrigation device
is described. The principles of nasal and throat irrigation
apply well to irrigation of the ear. In this design, 3 balanced,
pulsating water jets are used which do not strike the ear drum;
instead they rock the wax for removal, avoiding the trauma of
pressure on the ear drum or jamming the stapes back and forth.
