How to rinse the nasal cavities?

Abstract

Aim: Development of an effective method of rinsing the nasal cavities and paranasal sinuses using the Zatoxin Rinse kit. Material and methods: In order to develop recommendations for rinsing the nasal cavities, a cadaver head specimen from Poznań Lab was used. The nasal cavities were rinsed with a methylene blue solution - 0.8 ml of 10% methylene blue in 240 ml of water. Rinsing was performed in the standard recommended position - the head tilted slightly forward (approx. 20–30 degrees) and to the side – approx. 45 degrees. After endoscopic examination, endoscopic surgery of the paranasal sinuses was performed and the staining of the mucosa of the paranasal sinuses was assessed. The nasal cavities were rinsed again with a solution of water and methylene blue in the head position as described above. Endoscopic examination was performed with the assessment of the staining of the nasal mucosa and paranasal sinuses, and the rinsing was repeated with the head tilted forward to 60 degrees and laterally to 45 degrees. The staining of the mucosa was recorded during the endoscopic examination. Results: The nasal rinsing performed allowed the fluid to flow along the turbinates into the nasopharyngeal region and then out. After opening the paranasal sinuses, it turned out that only a small amount of methylene blue had penetrated into the maxillary sinuses; There was also no staining of the mucosa within the ethmoid cells, the frontal sinus or the sphenoid sinus. Rinsing the nasal cavities again in the same position, but after the ethmoidectomy, showed poor penetration of methylene blue into the ethmoid region, the frontal sinus ostium and the sphenoid sinus ostium. The re-rinsing of the nasal cavities with the head tilted forward by at least 60 degrees and to the side by 45 degrees resulted in a stronger staining of the rush top and the staining of the entrance to the frontal sinus with methylene blue. Conclusions: The way the head is positioned when using Zatoxin Rinse should be adapted to the disease, and in the case of surgical treatment, to the type of surgery performed and to which sinuses are affected by the disease, so that the solution reaches the required regions.