Battle of the Nasal Washes

October 8, 2008 -- How many times are children admonished not to put things up their noses? Yet somehow fingers, food and small toys eventually get up there and a disgruntled parent, teacher, doctor or other unfortunate party is stuck with the slimy job of removing said object from those twin mucousal highways.

So, it is understandable that the idea of snorting, squirting or pouring a salt water solution up the nose on purpose might be regarded with suspicion.

"You squeeze [water] in one nostril and out the other. It's freaky," said Dr. Donald Levy, medical director at the Osher Clinical Center for Complementary and Integrative Medical Therapies at Brigham and Women's Hospital in Boston. "But you're letting the body find a way to heal itself with minimal intervention."

Nasal irrigation, sometimes called a nasal rinse or, if you want to be posh, nasal lavage, can ease sinus-related problems, from the common cold to allergies. While there are several methods of getting the water up there in the first place, the general process involves water going up the nose and out again in order to flush out mucous, allergens and germs to ease sinus-related problems, from the common cold to allergies.

The simplest way to irrigate might be to sniff the water up from a cupped hand, while a nebulizer, which creates a fine mist that one breathes in to clear out the nasal passages, would be more complicated.

Ultimately, the method of nasal irrigation used depends on what people find works best to manage their symptoms, though there have been studies that show some methods are more effective than others.

A 2002 study published in the journal The Laryngoscope used a dyed solution laced with traceable markers to compare three methods of nasal irrigation to determine how much solution traveled through the nasal passages and where the solution went. Irrigation techniques that allowed more water to reach further into the nasal passages were deemed most effective.

The only technique that did not pass muster was the nebulizer, according to the study, because the vapor remains in the fleshy part of the nose and is ineffective at irrigating the nasal passages.

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The following are videos of three different nasal irrigation methods. With expert comments, see which method comes out on top and which one goes down the drain.

Robyn Curhan, 43, found relief from the pain and pressure in her sinuses by using a syringe to do saline nasal irrigation.

Watch a video demonstrating nasal irrigation using a syringe.

Using syringes to do nasal irrigation is an example of positive pressure irrigation, in which pressure is applied to a liquid so that it travels up the nostrils. The Laryngoscope study found positive pressure to be most effective at distributing a lot of solution far into the nasal passages.

Flushing a large area of the nasal passages clears mucous buildup and irritating allergens, allowing fluids in the sinuses -- the large and small cavernous areas concentrated around the nose, behind the eyes and up into the forehead -- to drain freely through the nose.

Clearing these regions helps prevent the pain and pressure that occur due to backed up sinus fluids during a cold or severe allergies.