Nasal Irrigation Instructions

Standard Saline Irrigation

For general nasal hygiene, post-operative care, and mild nasal congestion

Home-prepared recipe (240 mL):

• ½ litre of water — boiled then cooled to room temperature
• 1 teaspoon of non-iodised salt
• ¼ teaspoon of bicarbonate of soda

Mix well until dissolved. Irrigate once or twice daily as directed. Alternatively, use pre-packaged sachets (NeilMed SinuSal or equivalent) with a large-volume squeeze bottle — this is the preferred and most convenient method.

Budesonide (Pulmicort) Nasal Irrigation

For chronic rhinosinusitis and nasal polyp disease — use only if prescribed by Dr Roth

1. Prepare your 240 mL NeilMed Sinus Rinse bottle with saline solution as normal — fill to the top line and add the salt sachet
2. Add one respule of budesonide 0.5 mg/2 mL (Pulmicort) to the bottle
3. Shake the bottle well to ensure the budesonide is fully dissolved and mixed
4. In the morning, rinse 60 mL (one quarter of the bottle) into each nostril — using half the bottle total
5. In the evening, rinse the remaining half of the solution — 60 mL into each nostril

The total daily dose is one respule of budesonide, divided across morning and evening irrigations. Do not alter the dose without discussing with Dr Roth.

Diprosone Solution Irrigation

Use only if prescribed by Dr Roth

1. Prepare your NeilMed Sinus Rinse bottle with saline solution as normal
2. Add 2.5 cm of Diprosone OV 0.5 mg/g cream from the 30 g tube to the bottle
3. Shake well to dissolve the cream
4. Irrigate as directed by Dr Roth

Equipment

Use a large-volume delivery bottle — NeilMed Sinus Rinse or Flo Sinus Rinse. Small nasal pump sprays are not adequate for post-operative irrigation or medicated rinses. The large-volume squeeze bottle delivers the pressure and volume needed to clear the nasal passages effectively.

Water Safety

Always use water that has been boiled and cooled to room temperature, or sterile/distilled water. Tap water in Australia is generally safe but boiling eliminates the very small risk of waterborne organisms reaching the nasal passages during irrigation.

Technique

Lean over the sink with your head tilted slightly forward and to one side. Insert the bottle tip into the upper nostril. Squeeze steadily — the solution should flow through the nasal passage and exit from the lower nostril or mouth. Breathe through your mouth throughout. Repeat on the other side. Gently blow the nose to clear residual fluid after irrigating.

Bottle Hygiene

Rinse the bottle with clean water after each use. Store with the lid off and allow to air-dry completely between uses. Clean the bottle and tip thoroughly at least twice per week. Replace the bottle every one to two months or if you notice any discolouration or odour.

Frequency

Twice daily is the standard frequency recommended after nasal and sinus surgery, and for active sinus disease. Once daily is appropriate for ongoing maintenance after recovery. The specific frequency recommended for your situation will have been discussed at your appointment.