Keeping Nasal Irrigation Clean

Millions of Americans use Neti Pots, or sinus rinse bottles, or other reusable vessels to irrigate their noses and sinuses.  Medical journal reports over the years have surfaced showing these rinses may be harmful, carry bacteria (or worse!) and have even been linked to death.  One of the earlier studies from Laryngoscope showed after six weeks of use, 97% of the bottles were found contaminated with bacteria.  Worse yet over half of patients and their bottles actually had simultaneous infection/contamination with Staph aureus.  Electron microscopy actually demonstrated bacterial biofilms on 4 of 6 tested bottles, which probably lead to the persistent contamination.

In the lab the researchers tested different cleaning methods.  They found that microwaving the bottles for 2 minutes or cleaning the bottles with a chlorine-based cleaner (similar to bleach) were the only ways to completely eradicate the contamination.  Using a strong detergent was also helpful, but not to the same degree.
Even when using clear sterilized saline solution, many doctors feel that such large volume flushes through the sinuses risk pushing bacteria from the nostril skin far back into the recesses of the sinuses where they don’t belong.  Most of us at Advanced ENT prefer a low-volume gentle saline mist rather than a large volume flush.  Powered nebulizers or premixed bottles are great options!
What this means is we have to be very careful about using these reusable containers.  And we have to be sure we are keeping them clean to prevent a viscous cycle of self-contamination.