Nasal Irrigations: A 360-Degree View in Clinical Practice

DOI record: { "DOI": "10.3390/medicina61081402", "ISSN": [ "1648-9144" ], "URL": "http://dx.doi.org/10.3390/medicina61081402", "abstract": "<jats:p>Nasal irrigation (NI) is an effective, safe, low-cost strategy for treating and preventing upper respiratory tract diseases. High-volume, low-pressure saline irrigations are the most efficient method for removing infectious agents, allergens, and inflammatory mediators. This article reviews clinical evidence supporting NI use in various conditions: nasal congestion in infants, recurrent respiratory infections, acute and chronic rhinosinusitis, allergic and gestational rhinitis, empty nose syndrome, and post-endoscopic sinus surgery care. NI improves symptoms, reduces recurrence, enhances the efficacy of topical drugs, and decreases the need for antibiotics and decongestants. During the COVID-19 pandemic, NI has also been explored as a complementary measure to reduce viral load. Due to the safe profile and mechanical cleansing action on inflammatory mucus, nasal irrigations represent a valuable adjunctive treatment across a wide range of sinonasal conditions.</jats:p>", "alternative-id": [ "medicina61081402" ], "author": [ { "ORCID": "https://orcid.org/0000-0002-9765-8006", "affiliation": [ { "name": "Pediatric Unit, Ospedale Vito Fazzi, ASL Lecce, 73100 Lecce, Italy" } ], "authenticated-orcid": false, "family": "Pecoraro", "given": "Luca", "sequence": "first" }, { "affiliation": [ { "name": "Pediatric Unit, Ospedale Vito Fazzi, ASL Lecce, 73100 Lecce, Italy" } ], "family": "Di Muri", "given": "Elisabetta", "sequence": "additional" }, { "affiliation": [ { "name": "Pediatric Unit, Ospedale Vito Fazzi, ASL Lecce, 73100 Lecce, Italy" } ], "family": "Lezzi", "given": "Gianluca", "sequence": "additional" }, { "affiliation": [ { "name": "Pediatric Department, University of Bari Aldo Moro, 70121 Bari, Italy" } ], "family": "Picciolo", "given": "Silvia", "sequence": "additional" }, { "affiliation": [ { "name": "Pediatric Department, University of Bari Aldo Moro, 70121 Bari, Italy" } ], "family": "De Musso", "given": "Marta", "sequence": "additional" }, { "ORCID": "https://orcid.org/0000-0001-7746-8267", "affiliation": [ { "name": "Pediatric Unit, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, 37129 Verona, Italy" } ], "authenticated-orcid": false, "family": "Piazza", "given": "Michele", "sequence": "additional" }, { "affiliation": [ { "name": "Private Practice Pediatric Allergist, 20100 Milan, Italy" } ], "family": "Bosoni", "given": "Mariangela", "sequence": "additional" }, { "ORCID": "https://orcid.org/0000-0001-9789-7878", "affiliation": [ { "name": "Department of Experimental Medicine Pediatric Section, University of Salento Hospital “Vito Fazzi”, 73100 Lecce, Italy" } ], "authenticated-orcid": false, "family": "Indrio", "given": "Flavia", "sequence": "additional" } ], "container-title": "Medicina", "container-title-short": "Medicina", "content-domain": { "crossmark-restriction": false, "domain": [] }, "created": { "date-parts": [ [ 2025, 8, 4 ] ], "date-time": "2025-08-04T09:41:17Z", "timestamp": 1754300477000 }, "deposited": { "date-parts": [ [ 2025, 8, 4 ] ], "date-time": "2025-08-04T10:25:58Z", "timestamp": 1754303158000 }, "indexed": { "date-parts": [ [ 2025, 8, 5 ] ], "date-time": "2025-08-05T00:01:56Z", "timestamp": 1754352116932, "version": "3.41.2" }, "is-referenced-by-count": 0, "issue": "8", "issued": { "date-parts": [ [ 2025, 8, 1 ] ] }, "journal-issue": { "issue": "8", "published-online": { "date-parts": [ [ 2025, 8 ] ] } }, "language": "en", "license": [ { "URL": "https://creativecommons.org/licenses/by/4.0/", "content-version": "vor", "delay-in-days": 0, "start": { "date-parts": [ [ 2025, 8, 1 ] ], "date-time": "2025-08-01T00:00:00Z", "timestamp": 1754006400000 } } ], "link": [ { "URL": "https://www.mdpi.com/1648-9144/61/8/1402/pdf", "content-type": "unspecified", "content-version": "vor", "intended-application": "similarity-checking" } ], "member": "1968", "original-title": [], "page": "1402", "prefix": "10.3390", "published": { "date-parts": [ [ 2025, 8, 1 ] ] }, "published-online": { "date-parts": [ [ 2025, 8, 1 ] ] }, "publisher": "MDPI AG", "reference": [ { "key": "ref_1", "unstructured": "Math, S. (2025, May 20). Yoga Magazine: Neti-Nasal Cleaning. Available online: http://www.yogamag.net/archives/1990s/1991/9105/9105neti.html." }, { "key": "ref_2", "unstructured": "Rama, S., Ballentine, R., and Hymes, A. (1998). Science of Breath: A Practical Guide, Himalayan Institute Press." }, { "DOI": "10.1016/S0140-6736(01)83808-3", "article-title": "The nature of discharges and douches", "author": "Wingrave", "doi-asserted-by": "crossref", "first-page": "1373", "journal-title": "Lancet", "key": "ref_3", "volume": "159", "year": "1902" }, { "article-title": "Nasal lavage", "author": "Burns", "first-page": "83", "journal-title": "J. Otholaryngol.", "key": "ref_4", "volume": "21", "year": "1992" }, { "DOI": "10.1177/0194599816630310", "article-title": "Acute rhinosinusitis: Prescription patterns in a real-world setting", "author": "Benninger", "doi-asserted-by": "crossref", "first-page": "957", "journal-title": "Otolaryngol. Head Neck Surg.", "key": "ref_5", "volume": "154", "year": "2016" }, { "DOI": "10.1002/alr.21096", "article-title": "Topical therapies in managing chronic rhinosinusitis: An evidence-based review with recommendations", "author": "Rudmik", "doi-asserted-by": "crossref", "first-page": "281", "journal-title": "Int. Forum Allergy Rhinol.", "key": "ref_6", "volume": "3", "year": "2013" }, { "DOI": "10.2500/ajra.2016.30.4373", "article-title": "Practice patterns in pediatric chronic rhinosinusitis: A survey of the American Rhinologic Society", "author": "Beswick", "doi-asserted-by": "crossref", "first-page": "418", "journal-title": "Am. J. Rhinol. Allergy", "key": "ref_7", "volume": "30", "year": "2016" }, { "DOI": "10.1097/01.mlg.0000150671.45484.87", "article-title": "Trends in managing pediatric chronic sinusitis: Survey of the American Society of Pediatric Otolaryngology", "author": "Sobol", "doi-asserted-by": "crossref", "first-page": "78", "journal-title": "Laryngoscope", "key": "ref_8", "volume": "115", "year": "2005" }, { "article-title": "Treatment of allergic rhinitis", "author": "Sur", "first-page": "985", "journal-title": "Am. Fam. Physician", "key": "ref_9", "volume": "92", "year": "2015" }, { "DOI": "10.1186/1824-7288-40-47", "article-title": "Nasal saline irrigation in preschool children: A survey of attitudes and prescribing habits of primary care pediatricians working in northern Italy", "author": "Marchisio", "doi-asserted-by": "crossref", "first-page": "47", "journal-title": "Ital. J. Pediatr.", "key": "ref_10", "volume": "40", "year": "2014" }, { "DOI": "10.1001/archoto.2007.19", "article-title": "Efficacy of isotonic nasal wash (seawater) in the treatment and prevention of rhinitis in children", "author": "Slapak", "doi-asserted-by": "crossref", "first-page": "67", "journal-title": "Arch. Otolaryngol. Head Neck Surg.", "key": "ref_11", "volume": "134", "year": "2008" }, { "DOI": "10.3390/ijerph14050516", "doi-asserted-by": "crossref", "key": "ref_12", "unstructured": "Principi, N., and Esposito, S. (2017). Nasal Irrigation: An Imprecisely Defined Medical Procedure. Int. J. Environ. Res. Public Health, 14." }, { "DOI": "10.1164/ajrccm.160.2.9805081", "article-title": "Hypertonic saline nasal provocation stimulates nociceptive nerves, substance P release, and glandular mucous exocytosis in normal humans", "author": "Baraniuk", "doi-asserted-by": "crossref", "first-page": "655", "journal-title": "Am. J. Respir. Crit. Care Med.", "key": "ref_13", "volume": "160", "year": "1999" }, { "DOI": "10.1016/j.ijporl.2022.111183", "article-title": "Effectiveness of pediatric nasal irrigation solution with or without xylitol", "author": "Kurt", "doi-asserted-by": "crossref", "first-page": "111183", "journal-title": "Int. J. Pediatr. Otorhinolaryngol.", "key": "ref_14", "volume": "158", "year": "2022" }, { "DOI": "10.1016/j.anorl.2020.08.004", "article-title": "Paediatric nasal irrigation: The “fencing” method", "author": "Sagardoy", "doi-asserted-by": "crossref", "first-page": "107", "journal-title": "Eur. Ann. Otorhinolaryngol. Head Neck Dis.", "key": "ref_15", "volume": "138", "year": "2021" }, { "DOI": "10.1021/acs.estlett.5b00050", "article-title": "Total Virus and Bacteria Concentrations in Indoor and Outdoor Air", "author": "Prussin", "doi-asserted-by": "crossref", "first-page": "84", "journal-title": "Environ. Sci. Technol. Lett.", "key": "ref_16", "volume": "2", "year": "2015" }, { "key": "ref_17", "unstructured": "(2025, May 20). Airborne Microbes Part 2: How Many Bacteria Do We Breathe in Each Day. Available online: https://steemit.com/steemstem/@tking77798/airborne-microbes-part-2-how-many-bacteria-do-we-breathe-in-each-day." }, { "DOI": "10.1016/j.jaci.2016.02.023", "article-title": "A work group report on ultrafine particles (American Academy of Allergy, Asthma & Immunology): Why ambient ultrafine and engineered nanoparticles should receive special attention for possible adverse health outcomes in human subjects", "author": "Li", "doi-asserted-by": "crossref", "first-page": "386", "journal-title": "J. Allergy Clin. Immunol.", "key": "ref_18", "volume": "138", "year": "2016" }, { "DOI": "10.1016/j.jaci.2019.04.012", "article-title": "An update on immunologic mechanisms in the respiratory mucosa in response to air pollutants", "author": "Huff", "doi-asserted-by": "crossref", "first-page": "1989", "journal-title": "J. Allergy Clin. Immunol.", "key": "ref_19", "volume": "143", "year": "2019" }, { "DOI": "10.1111/j.1398-9995.2007.01393.x", "article-title": "Allergenic pollen and pollen allergy in Europe", "author": "Cecchi", "doi-asserted-by": "crossref", "first-page": "976", "journal-title": "Allergy", "key": "ref_20", "volume": "62", "year": "2007" }, { "DOI": "10.1038/206935b0", "article-title": "‘Isoallergens’ from rye grass pollen", "author": "Johnson", "doi-asserted-by": "crossref", "first-page": "935", "journal-title": "Nature", "key": "ref_21", "volume": "206", "year": "1965" }, { "article-title": "Allergens and the genetics of allergy", "author": "Sela", "first-page": "271", "journal-title": "The Antigens", "key": "ref_22", "volume": "Volume III", "year": "1975" }, { "DOI": "10.1111/all.13092", "article-title": "Defining pollen exposure times for clinical trials of allergen immunotherapy for pollen-induced rhinoconjunctivitis—An EAACI position paper", "author": "Pfaar", "doi-asserted-by": "crossref", "first-page": "713", "journal-title": "Allergy", "key": "ref_23", "volume": "72", "year": "2017" }, { "DOI": "10.1007/s10453-021-09720-9", "article-title": "Threshold values of grass pollen (Poaceae) concentrations and increase in emergency department visits, hospital admissions, drug consumption and allergic symptoms in patients with allergic rhinitis: A systematic review", "author": "Becker", "doi-asserted-by": "crossref", "first-page": "633", "journal-title": "Aerobiologia", "key": "ref_24", "volume": "37", "year": "2021" }, { "DOI": "10.1111/all.14111", "article-title": "Pollen season is reflected on symptom load for grass and birch pollen-induced allergic rhinitis in different geographic areas—An EAACI Task Force Report", "author": "Pfaar", "doi-asserted-by": "crossref", "first-page": "1099", "journal-title": "Allergy", "key": "ref_25", "volume": "75", "year": "2020" }, { "DOI": "10.1016/j.jaci.2016.04.010", "article-title": "IgE in the diagnosis and treatment of allergic disease", "author": "Schuyler", "doi-asserted-by": "crossref", "first-page": "1662", "journal-title": "J. Allergy Clin. Immunol.", "key": "ref_26", "volume": "137", "year": "2016" }, { "article-title": "The distribution of dust mite allergen in the houses of patients with asthma", "author": "Tovey", "first-page": "630", "journal-title": "Am. Rev. Respir. Dis.", "key": "ref_27", "volume": "124", "year": "1981" }, { "DOI": "10.1038/289592a0", "article-title": "Mite faeces are a major source of house dust allergens", "author": "Tovey", "doi-asserted-by": "crossref", "first-page": "592", "journal-title": "Nature", "key": "ref_28", "volume": "289", "year": "1981" }, { "DOI": "10.1016/j.iac.2010.08.002", "article-title": "Virus/allergen interactions and exacerbations of asthma", "author": "Kloepfer", "doi-asserted-by": "crossref", "first-page": "553", "journal-title": "Immunol. Allergy Clin. N. Am.", "key": "ref_29", "volume": "30", "year": "2010" }, { "DOI": "10.1016/j.jaci.2012.03.040", "article-title": "High titers of IgE antibody to dust mite allergen and risk for wheezing among asthmatic children infected with rhinovirus", "author": "Avila", "doi-asserted-by": "crossref", "first-page": "1499", "journal-title": "J. Allergy Clin. Immunol.", "key": "ref_30", "volume": "129", "year": "2012" }, { "DOI": "10.1046/j.1365-2222.2002.01542.x", "article-title": "Allergen-induced bronchial inflammation in house dust mite-allergic patients with or without asthma", "author": "Out", "doi-asserted-by": "crossref", "first-page": "1720", "journal-title": "Clin. Exp. Allergy", "key": "ref_31", "volume": "32", "year": "2002" }, { "DOI": "10.1164/rccm.201703-0450ED", "article-title": "Mite Avoidance as a Logical Treatment for Severe Asthma in Childhood. Why Not?", "author": "Woodfolk", "doi-asserted-by": "crossref", "first-page": "119", "journal-title": "Am. J. Respir. Crit. Care Med.", "key": "ref_32", "volume": "196", "year": "2017" }, { "DOI": "10.1164/ajrccm/141.2.361", "article-title": "Airborne concentrations and particle size distribution of allergen derived from domestic cats (Felis domesticus). Measurements using cascade impactor, liquid impinger, and a two-site monoclonal antibody assay for Fel d I", "author": "Luczynska", "doi-asserted-by": "crossref", "first-page": "361", "journal-title": "Am. Rev. Respir. Dis.", "key": "ref_33", "volume": "141", "year": "1990" }, { "DOI": "10.1016/j.jaci.2005.05.012", "article-title": "Airborne endotoxin in homes with domestic animals: Implications for cat-specific tolerance", "author": "Custis", "doi-asserted-by": "crossref", "first-page": "384", "journal-title": "J. Allergy Clin. Immunol.", "key": "ref_34", "volume": "116", "year": "2005" }, { "DOI": "10.1007/BF00451968", "article-title": "Nose drops and the common cold", "author": "Ozsoylu", "doi-asserted-by": "crossref", "first-page": "294", "journal-title": "Eur. J. Pediatr.", "key": "ref_35", "volume": "144", "year": "1985" }, { "DOI": "10.1542/peds.109.1.165a", "article-title": "Nasal saline for acute sinusitis", "author": "Karadag", "doi-asserted-by": "crossref", "first-page": "165", "journal-title": "Pediatrics", "key": "ref_36", "volume": "109", "year": "2002" }, { "DOI": "10.1378/chest.124.5.2036", "article-title": "A reappraisal of nasal saline solution use in chronic sinusitis", "author": "Kurtaran", "doi-asserted-by": "crossref", "first-page": "2036", "journal-title": "Chest", "key": "ref_37", "volume": "124", "year": "2003" }, { "DOI": "10.1016/j.jaci.2005.03.049", "article-title": "Striking deposition of toxic eosinophil major basic protein in mucus: Implications for chronic rhinosinusitis", "author": "Ponikau", "doi-asserted-by": "crossref", "first-page": "362", "journal-title": "J. Allergy Clin. Immunol.", "key": "ref_38", "volume": "116", "year": "2005" }, { "DOI": "10.1378/chest.106.5.1487", "article-title": "Nasal hyperthermia and simple irrigation for perennial rhinitis. Changes in inflammatory mediators", "author": "Georgitis", "doi-asserted-by": "crossref", "first-page": "1487", "journal-title": "Chest", "key": "ref_39", "volume": "106", "year": "1994" }, { "DOI": "10.1097/00005537-200203000-00029", "article-title": "Nasal mucociliary transport: New evidence for a key role of ciliary beat frequency", "author": "Boek", "doi-asserted-by": "crossref", "first-page": "570", "journal-title": "Laryngoscope", "key": "ref_40", "volume": "112", "year": "2002" }, { "DOI": "10.1097/00005537-199704000-00013", "article-title": "Mucociliary clearance and buffered hypertonic saline solution", "author": "Talbot", "doi-asserted-by": "crossref", "first-page": "500", "journal-title": "Laryngoscope", "key": "ref_41", "volume": "107", "year": "1997" }, { "DOI": "10.1046/j.1365-2273.2000.00420.x", "article-title": "The effect of hypertonicity on nasal mucociliary clearance", "author": "Homer", "doi-asserted-by": "crossref", "first-page": "558", "journal-title": "Clin. Otolaryngol. Allied Sci.", "key": "ref_42", "volume": "25", "year": "2000" }, { "article-title": "Saline nasal irrigation for upper respiratory conditions", "author": "Rabago", "first-page": "1117", "journal-title": "Am. Fam. Physician", "key": "ref_43", "volume": "80", "year": "2009" }, { "DOI": "10.1016/j.cmet.2015.02.003", "article-title": "Cutaneous Na+ storage strengthens the antimicrobial barrier function of the skin and boosts macrophage-driven host defense", "author": "Jantsch", "doi-asserted-by": "crossref", "first-page": "493", "journal-title": "Cell Metab.", "key": "ref_44", "volume": "21", "year": "2015" }, { "DOI": "10.1038/s41598-018-31936-y", "doi-asserted-by": "crossref", "key": "ref_45", "unstructured": "Ramalingam, S., Cai, B., Wong, J., Twomey, M., Chen, R., Fu, R.M., Boote, T., McCaughan, H., Griffiths, S.J., and Haas, J.G. (2018). Antiviral innate immune response in non-myeloid cells is augmented by chloride ions via an increase in intracellular hypochlorous acid levels. Sci. Rep., 8." }, { "DOI": "10.1038/s41598-018-37703-3", "doi-asserted-by": "crossref", "key": "ref_46", "unstructured": "Ramalingam, S., Graham, C., Dove, J., Morrice, L., and Sheikh, A. (2019). A pilot, open labelled, randomised controlled trial of hypertonic saline nasal irrigation and gargling for the common cold. Sci. Rep., 9." }, { "DOI": "10.1016/S0091-6749(98)70166-6", "article-title": "Treatment with hypertonic saline versus normal saline nasal wash of pediatric chronic sinusitis", "author": "Shoseyov", "doi-asserted-by": "crossref", "first-page": "602", "journal-title": "J. Allergy Clin. Immunol.", "key": "ref_47", "volume": "101", "year": "1998" }, { "DOI": "10.1016/0140-6736(92)92533-L", "article-title": "Hypertonic saline solution for wound dressing", "author": "Mangete", "doi-asserted-by": "crossref", "first-page": "1351", "journal-title": "Lancet", "key": "ref_48", "volume": "340", "year": "1992" }, { "DOI": "10.1016/0140-6736(93)90048-L", "article-title": "Hypertonic saline solution as disinfectant", "author": "Lowthian", "doi-asserted-by": "crossref", "first-page": "182", "journal-title": "Lancet", "key": "ref_49", "volume": "341", "year": "1993" }, { "DOI": "10.1159/000321044", "article-title": "Nasal drug delivery in humans", "author": "Bitter", "doi-asserted-by": "crossref", "first-page": "20", "journal-title": "Curr. Probl. Dermatol.", "key": "ref_50", "volume": "40", "year": "2011" }, { "DOI": "10.1002/alr.22330", "article-title": "Nasal saline irrigation: A clinical update", "author": "Succar", "doi-asserted-by": "crossref", "first-page": "S4", "journal-title": "Int. Forum Allergy Rhinol.", "key": "ref_51", "volume": "9", "year": "2019" }, { "DOI": "10.1177/00034894221112514", "article-title": "Consensus on nasal irrigation in infants: A Delphi study", "author": "Audag", "doi-asserted-by": "crossref", "first-page": "674", "journal-title": "Ann. Otol. Rhinol. Laryngol.", "key": "ref_52", "volume": "132", "year": "2023" }, { "DOI": "10.1097/01.mlg.0000149463.95950.c5", "article-title": "A comparative study of three methods of nasal irrigation", "author": "Wormald", "doi-asserted-by": "crossref", "first-page": "2224", "journal-title": "Laryngoscope", "key": "ref_53", "volume": "114", "year": "2004" }, { "DOI": "10.1002/alr.21172", "article-title": "Distribution of topical agents to the paranasal sinuses: An evidence-based review with recommendations", "author": "Thomas", "doi-asserted-by": "crossref", "first-page": "691", "journal-title": "Int. Forum Allergy Rhinol.", "key": "ref_54", "volume": "3", "year": "2013" }, { "DOI": "10.1002/alr.20057", "article-title": "Prospective evaluation of aerosol delivery by a powered nasal nebuliser in the cadaver model", "author": "Manes", "doi-asserted-by": "crossref", "first-page": "366", "journal-title": "Int. Forum Allergy Rhinol.", "key": "ref_55", "volume": "1", "year": "2011" }, { "DOI": "10.1016/j.jclinepi.2013.12.002", "article-title": "Defining consensus: A systematic review recommends methodologic criteria for reporting of Delphi studies", "author": "Diamond", "doi-asserted-by": "crossref", "first-page": "401", "journal-title": "J. Clin. Epidemiol.", "key": "ref_56", "volume": "67", "year": "2014" }, { "DOI": "10.1111/apa.13282", "article-title": "Nasal irrigation with saline solution significantly improves oxygen saturation in infants with bronchiolitis", "author": "Schreiber", "doi-asserted-by": "crossref", "first-page": "292", "journal-title": "Acta Paediatr.", "key": "ref_57", "volume": "105", "year": "2016" }, { "DOI": "10.1136/archdischild-2015-309587", "article-title": "Is nasal suctioning warranted before measuring O2 saturation in infants with bronchiolitis?", "author": "Baraldi", "doi-asserted-by": "crossref", "first-page": "114", "journal-title": "Arch. Dis. Child.", "key": "ref_58", "volume": "101", "year": "2016" }, { "DOI": "10.1542/peds.87.2.129", "article-title": "Upper respiratory tract infections in young children: Duration and frequency of com-plications", "author": "Wald", "doi-asserted-by": "crossref", "first-page": "129", "journal-title": "Pediatrics", "key": "ref_59", "volume": "87", "year": "1991" }, { "DOI": "10.1136/thorax.55.suppl_2.S20", "article-title": "Epidemiology of chronic rhinosinusitis", "author": "Watelet", "doi-asserted-by": "crossref", "first-page": "S20", "journal-title": "Thorax", "key": "ref_60", "volume": "55", "year": "2000" }, { "DOI": "10.1001/archpedi.156.11.1114", "article-title": "Antibiotic prescribing by primary care physicians for children with upper respiratory tract infections", "author": "Nash", "doi-asserted-by": "crossref", "first-page": "1114", "journal-title": "Arch. Pediatr. Adolesc. Med.", "key": "ref_61", "volume": "156", "year": "2002" }, { "DOI": "10.1016/j.ijporl.2011.12.022", "article-title": "Nasal saline irrigation in children: A study of compliance and tolerance", "author": "Jeffe", "doi-asserted-by": "crossref", "first-page": "409", "journal-title": "Int. J. Pediatr. Otorhinolaryngol.", "key": "ref_62", "volume": "76", "year": "2012" }, { "article-title": "The environment and disease: Association or causation?", "author": "Hill", "first-page": "295", "journal-title": "Proc. R. Soc. Med.", "key": "ref_63", "volume": "58", "year": "1965" }, { "article-title": "[Prophylaxis of acute respiratory infections in children’s collectives: Results of treatment with nasal and nasopharyngeal irrigation]", "author": "Kiselev", "first-page": "44", "journal-title": "Vestn. Otorinolaringol.", "key": "ref_64", "volume": "1", "year": "2012" }, { "DOI": "10.1080/00016480410017657", "article-title": "A daily nasal spray with saline prevents symptoms of rhinitis", "author": "Tano", "doi-asserted-by": "crossref", "first-page": "1059", "journal-title": "Acta Otolaryngol.", "key": "ref_65", "volume": "124", "year": "2004" }, { "DOI": "10.1002/alr.21604", "article-title": "The effect of nasal irrigation formulation on the antimicrobial activity of nasal secretions", "author": "Woods", "doi-asserted-by": "crossref", "first-page": "1104", "journal-title": "Int. Forum Allergy Rhinol.", "key": "ref_66", "volume": "5", "year": "2015" }, { "DOI": "10.1016/S0024-3205(02)01740-X", "article-title": "Direct antimicrobial properties of substance P", "author": "Kowalska", "doi-asserted-by": "crossref", "first-page": "747", "journal-title": "Life Sci.", "key": "ref_67", "volume": "71", "year": "2002" }, { "DOI": "10.2174/138920312804871139", "article-title": "Direct and indirect antimicrobial activities of neuropeptides and their therapeutic potential", "author": "Augustyniak", "doi-asserted-by": "crossref", "first-page": "723", "journal-title": "Curr. Protein Pept. Sci.", "key": "ref_68", "volume": "13", "year": "2012" }, { "DOI": "10.4049/jimmunol.0803959", "article-title": "LL-37 complexation with glycosaminoglycans in cystic fibrosis lungs inhibits antimicrobial activity, which can be restored by hypertonic saline", "author": "Bergsson", "doi-asserted-by": "crossref", "first-page": "543", "journal-title": "J. Immunol.", "key": "ref_69", "volume": "183", "year": "2009" }, { "DOI": "10.4103/ijpvm.IJPVM_277_20", "article-title": "COVID-19 infection and children: A comprehensive review", "author": "Mehrabani", "doi-asserted-by": "crossref", "first-page": "157", "journal-title": "Int. J. Prev. Med.", "key": "ref_70", "volume": "11", "year": "2020" }, { "DOI": "10.1542/peds.2017-0933", "article-title": "Epidemiology and risk factors of infection in early childhood", "author": "Vissing", "doi-asserted-by": "crossref", "first-page": "e20170933", "journal-title": "Pediatrics", "key": "ref_71", "volume": "141", "year": "2018" }, { "DOI": "10.1002/ppul.20828", "article-title": "Acute respiratory symptoms and general illness during the first year of life: A population-based birth cohort study", "author": "Holst", "doi-asserted-by": "crossref", "first-page": "584", "journal-title": "Pediatr. Pulmonol.", "key": "ref_72", "volume": "43", "year": "2008" }, { "DOI": "10.1155/2012/207605", "article-title": "It takes a mouth to eat and a nose to breathe: Abnormal oral respiration affects neonates’ oral competence and systemic adaptation", "author": "Trabalon", "doi-asserted-by": "crossref", "first-page": "207605", "journal-title": "Int. J. Pediatr.", "key": "ref_73", "volume": "2012", "year": "2012" }, { "DOI": "10.1097/00006454-200009000-00034", "article-title": "Recurrent and persistent otitis media", "author": "Pichichero", "doi-asserted-by": "crossref", "first-page": "911", "journal-title": "Pediatr. Infect. Dis. J.", "key": "ref_74", "volume": "19", "year": "2000" }, { "article-title": "Saline nasal irrigation for acute upper respir-atory tract infections in infants and children: A systematic review and meta-analysis", "author": "Cabaillot", "first-page": "151", "journal-title": "Paediatr. Respir. Rev.", "key": "ref_75", "volume": "36", "year": "2020" }, { "DOI": "10.1177/039463201302600112", "article-title": "Effects of sodium hyaluronate in children with recurrent upper respiratory tract infections: Results of a randomised controlled study", "author": "Macchi", "doi-asserted-by": "crossref", "first-page": "127", "journal-title": "Int. J. Immunopathol. Pharmacol.", "key": "ref_76", "volume": "26", "year": "2013" }, { "DOI": "10.1016/j.jcv.2004.02.011", "article-title": "Viral titers in nasal lining fluid compared to viral titers in nasal washes during experimental rhinovirus infection", "author": "Hendley", "doi-asserted-by": "crossref", "first-page": "326", "journal-title": "J. Clin. Virol.", "key": "ref_77", "volume": "30", "year": "2004" }, { "DOI": "10.1001/jamaoto.2020.1622", "article-title": "Benefits and safety of nasal saline irrigations in a pandemic—Washing COVID-19 away", "author": "Farrell", "doi-asserted-by": "crossref", "first-page": "787", "journal-title": "JAMA Otolaryngol. Head Neck Surg.", "key": "ref_78", "volume": "146", "year": "2020" }, { "DOI": "10.4103/lungindia.lungindia_241_20", "article-title": "Nasopharyngeal wash in preventing and treating upper respiratory tract infections: Could it prevent COVID-19?", "author": "Singh", "doi-asserted-by": "crossref", "first-page": "246", "journal-title": "Lung India", "key": "ref_79", "volume": "37", "year": "2020" }, { "DOI": "10.1002/jmv.26514", "article-title": "Lowering the transmission and spread of human coronavirus", "author": "Meyers", "doi-asserted-by": "crossref", "first-page": "1605", "journal-title": "J. Med. Virol.", "key": "ref_80", "volume": "93", "year": "2021" }, { "DOI": "10.1007/s00784-023-05078-z", "article-title": "The role of the oral cavity in SARS-CoV-2 and other viral infections", "author": "Hoffmann", "doi-asserted-by": "crossref", "first-page": "15", "journal-title": "Clin. Oral Investig.", "key": "ref_81", "volume": "27", "year": "2023" }, { "DOI": "10.1007/s00228-021-03102-3", "article-title": "Essentials in saline pharmacology for nasal or respiratory hygiene in times of COVID-19", "author": "Huijghebaert", "doi-asserted-by": "crossref", "first-page": "1275", "journal-title": "Eur. J. Clin. Pharmacol.", "key": "ref_82", "volume": "77", "year": "2021" }, { "DOI": "10.1136/thoraxjnl-2021-217561", "article-title": "Respiratory epithelial cell responses to SARS-CoV-2 in COVID-19", "author": "Bridges", "doi-asserted-by": "crossref", "first-page": "203", "journal-title": "Thorax", "key": "ref_83", "volume": "77", "year": "2022" }, { "DOI": "10.1177/01455613221123737", "article-title": "Rapid initiation of nasal saline irrigation to reduce severity in high-risk COVID+ outpatients", "author": "Baxter", "doi-asserted-by": "crossref", "first-page": "30S", "journal-title": "Ear Nose Throat J.", "key": "ref_84", "volume": "10", "year": "2024" }, { "DOI": "10.15585/mmwr.mm6930e1", "article-title": "Symptom duration and risk factors for delayed return to usual health among outpatients with COVID-19 in a multistate health care systems network–United States, March-June 2020", "author": "Tenforde", "doi-asserted-by": "crossref", "first-page": "993", "journal-title": "MMWR Morb. Mortal. Wkly. Rep.", "key": "ref_85", "volume": "69", "year": "2020" }, { "DOI": "10.1177/0145561320950491", "article-title": "Safety and impact of nasal lavages during viral infections such as SARS-CoV-2", "author": "Radulesco", "doi-asserted-by": "crossref", "first-page": "188S", "journal-title": "Ear Nose Throat J.", "key": "ref_86", "volume": "100", "year": "2021" }, { "DOI": "10.3892/br.2021.1494", "doi-asserted-by": "crossref", "key": "ref_87", "unstructured": "Gutiérrez-García, R., De La Cerda-Ángeles, J.C., Cabrera-Licona, A., Delgado-Enciso, I., Mervitch-Sigal, N., and Paz-Michel, B.A. (2022). Nasopharyngeal and oropharyngeal rinses with neutral electrolyzed water prevent COVID-19 in front-line health professionals: A randomized, open-label, controlled trial in a general hospital in Mexico City. Biomed. Rep., 16." }, { "DOI": "10.1111/j.1532-5415.2005.00529.x", "article-title": "Two outbreaks of severe respiratory disease in nursing homes associated with rhinovirus", "author": "Hicks", "doi-asserted-by": "crossref", "first-page": "284", "journal-title": "J. Am. Geriatr. Soc.", "key": "ref_88", "volume": "54", "year": "2006" }, { "DOI": "10.3181/00379727-106-26352", "article-title": "Effect of several inorganic salts on the infectivity of Mengo virus", "author": "Speir", "doi-asserted-by": "crossref", "first-page": "402", "journal-title": "Proc. Soc. Exp. Biol. Med.", "key": "ref_89", "volume": "106", "year": "1961" }, { "DOI": "10.1002/lary.24709", "article-title": "The prevalence of bacterial infection in acute rhinosinusitis: A systematic review and meta-analysis", "author": "Smith", "doi-asserted-by": "crossref", "first-page": "57", "journal-title": "Laryngoscope", "key": "ref_90", "volume": "125", "year": "2015" }, { "DOI": "10.1016/j.jaci.2005.08.044", "article-title": "Treating acute rhinosinusitis: Comparing efficacy and safety of mometasone furoate nasal spray, amoxicillin, and placebo", "author": "Meltzer", "doi-asserted-by": "crossref", "first-page": "1289", "journal-title": "J. Allergy Clin. Immunol.", "key": "ref_91", "volume": "116", "year": "2005" }, { "article-title": "Efficacy of daily hypertonic saline nasal irrigation among patients with sinusitis: A randomized controlled trial", "author": "Rabago", "first-page": "1049", "journal-title": "J. Fam. Pract.", "key": "ref_92", "volume": "51", "year": "2002" }, { "article-title": "Pathological and cytological changes of the nasal mucosa in acute rhinosinusitis: The role of hyaluronic acid as supportive therapy", "author": "Ciofalo", "first-page": "4411", "journal-title": "Eur. Rev. Med. Pharmacol. Sci.", "key": "ref_93", "volume": "21", "year": "2017" }, { "DOI": "10.4193/Rhin20.401", "article-title": "European Position Paper on Rhinosinusitis and Nasal Polyps 2020", "author": "Fokkens", "doi-asserted-by": "crossref", "first-page": "1", "journal-title": "Rhinology", "key": "ref_94", "volume": "58", "year": "2020" }, { "article-title": "Nasal douching in acute rhinosinusitis", "author": "Hildenbrand", "first-page": "346", "journal-title": "Laryngorhinootologie", "key": "ref_95", "volume": "90", "year": "2011" }, { "DOI": "10.1177/0194599815574247", "article-title": "Clinical practice guideline (update): Adult sinusitis executive summary", "author": "Rosenfeld", "doi-asserted-by": "crossref", "first-page": "598", "journal-title": "Otolaryngol. Head Neck Surg.", "key": "ref_96", "volume": "152", "year": "2015" }, { "article-title": "International consensus statement on allergy and rhinology: Rhinosinusitis", "author": "Orlandi", "first-page": "S22", "journal-title": "Int. Forum Allergy Rhinol.", "key": "ref_97", "volume": "6", "year": "2016" }, { "DOI": "10.1177/1945892421994999", "article-title": "Management of recurrent acute rhinosinusitis: A systematic review", "author": "Saltagi", "doi-asserted-by": "crossref", "first-page": "902", "journal-title": "Am. J. Rhinol. Allergy", "key": "ref_98", "volume": "35", "year": "2021" }, { "DOI": "10.1002/lary.24224", "article-title": "Long-term outcome of once daily nasal irrigation for treating pediatric chronic rhinosinusitis", "author": "Pham", "doi-asserted-by": "crossref", "first-page": "1000", "journal-title": "Laryngoscope", "key": "ref_99", "volume": "124", "year": "2014" }, { "DOI": "10.1016/j.anl.2013.07.008", "article-title": "Compliance and efficacy of saline irrigation in pediatric chronic rhinosinusitis", "author": "Hong", "doi-asserted-by": "crossref", "first-page": "46", "journal-title": "Auris Nasus Larynx", "key": "ref_100", "volume": "41", "year": "2014" }, { "DOI": "10.2500/ajra.2016.30.4297", "article-title": "Chronic rhinosinusitis: Epidemiology and burden of disease", "author": "Soler", "doi-asserted-by": "crossref", "first-page": "134", "journal-title": "Am. J. Rhinol. Allergy", "key": "ref_101", "volume": "30", "year": "2016" }, { "DOI": "10.1016/j.anai.2018.10.014", "article-title": "Pathophysiologic mechanisms of chronic rhinosinusitis and their roles in emerging disease endotypes", "author": "Cao", "doi-asserted-by": "crossref", "first-page": "33", "journal-title": "Ann. Allergy Asthma Immunol.", "key": "ref_102", "volume": "122", "year": "2019" }, { "DOI": "10.1007/s11882-010-0175-2", "article-title": "Quality of life in patients with chronic rhinosinusitis", "author": "Rudmik", "doi-asserted-by": "crossref", "first-page": "247", "journal-title": "Curr. Allergy Asthma Rep.", "key": "ref_103", "volume": "11", "year": "2011" }, { "DOI": "10.1002/alr.21217", "article-title": "Chronic rhinosinusitis and sleep: A contemporary review", "author": "Alt", "doi-asserted-by": "crossref", "first-page": "941", "journal-title": "Int. Forum Allergy Rhinol.", "key": "ref_104", "volume": "3", "year": "2013" }, { "DOI": "10.2500/ajr.2008.22.3172", "article-title": "Symptom-based presentation of chronic rhinosinusitis and symptom-specific outcomes after endoscopic sinus surgery", "author": "Soler", "doi-asserted-by": "crossref", "first-page": "297", "journal-title": "Am. J. Rhinol.", "key": "ref_105", "volume": "22", "year": "2008" }, { "DOI": "10.1177/000348941212100904", "article-title": "Etiology of nasal polyps in cystic fibrosis: Not a unimodal disease", "author": "Steinke", "doi-asserted-by": "crossref", "first-page": "579", "journal-title": "Ann. Otol. Rhinol. Laryngol.", "key": "ref_106", "volume": "121", "year": "2012" }, { "DOI": "10.1002/lary.21923", "article-title": "Safety and efficacy of once-daily nasal irrigation for the treatment of pediatric chronic rhinosinusitis", "author": "Wei", "doi-asserted-by": "crossref", "first-page": "1989", "journal-title": "Laryngoscope", "key": "ref_107", "volume": "121", "year": "2011" }, { "article-title": "Saline irrigation for chronic rhinosinusitis", "author": "Chong", "first-page": "CD011995", "journal-title": "Cochrane Database Syst Rev.", "key": "ref_108", "volume": "4", "year": "2016" }, { "article-title": "Clinical effects of sinus surgery and adjuvant therapy in cystic fibrosis patients—Can chronic lung infections be postponed?", "author": "Johansen", "first-page": "222", "journal-title": "Rhinology", "key": "ref_109", "volume": "51", "year": "2013" }, { "DOI": "10.3109/00016489.2014.962185", "article-title": "Simultaneous sinus and lung infections in patients with primary ciliary dyskinesia", "author": "Alanin", "doi-asserted-by": "crossref", "first-page": "58", "journal-title": "Acta Otolaryngol.", "key": "ref_110", "volume": "135", "year": "2015" }, { "DOI": "10.1016/S1569-1993(13)00150-1", "article-title": "Bacterial sinusitis can be a focus for initial lung colonisation and chronic lung infection in patients with cystic fibrosis", "author": "Aanaes", "doi-asserted-by": "crossref", "first-page": "S1", "journal-title": "J. Cyst. Fibros.", "key": "ref_111", "volume": "12", "year": "2013" }, { "DOI": "10.1002/oto2.101", "article-title": "Evaluating sinus microbiology by transplant status in persons with cystic fibrosis: A matched cohort study", "author": "Somayaji", "doi-asserted-by": "crossref", "first-page": "e101", "journal-title": "OTO Open", "key": "ref_112", "volume": "8", "year": "2024" }, { "DOI": "10.2147/JIR.S436450", "article-title": "Lymphatic vessels in chronic rhinosinusitis", "author": "Pesold", "doi-asserted-by": "crossref", "first-page": "865", "journal-title": "J. Inflamm. Res.", "key": "ref_113", "volume": "17", "year": "2024" }, { "DOI": "10.1007/s12070-014-0766-7", "article-title": "Hyaluronan in the treatment of chronic rhinosinusitis with nasal poly-posis", "author": "Cassandro", "doi-asserted-by": "crossref", "first-page": "299", "journal-title": "Indian J. Otolaryngol. Head Neck Surg.", "key": "ref_114", "volume": "67", "year": "2015" }, { "article-title": "Effect of sodium hyaluronate on mucociliary clearance after functional endoscopic sinus surgery", "author": "Gelardi", "first-page": "103", "journal-title": "Eur. Ann. Allergy Clin. Immunol.", "key": "ref_115", "volume": "45", "year": "2013" }, { "DOI": "10.1002/lary.21805", "article-title": "Staphylococcus aureus biofilms: Nemesis of endoscopic sinus surgery", "author": "Singhal", "doi-asserted-by": "crossref", "first-page": "1578", "journal-title": "Laryngoscope", "key": "ref_116", "volume": "121", "year": "2011" }, { "article-title": "Presence of hyaluronidase isoforms in nasal polyps", "author": "Hatziri", "first-page": "247", "journal-title": "Eur. Rev. Med. Pharmacol. Sci.", "key": "ref_117", "volume": "17", "year": "2013" }, { "DOI": "10.1288/00005537-198903000-00007", "article-title": "Functional endonasal sinus surgery (FESS) in the pediatric age group", "author": "Gross", "doi-asserted-by": "crossref", "first-page": "272", "journal-title": "Laryngoscope", "key": "ref_118", "volume": "99", "year": "1989" }, { "DOI": "10.1097/00020840-200502000-00014", "article-title": "Pediatric sinusitis: When do we operate?", "author": "Lieser", "doi-asserted-by": "crossref", "first-page": "60", "journal-title": "Curr. Opin. Otolaryngol. Head Neck Surg.", "key": "ref_119", "volume": "13", "year": "2005" }, { "DOI": "10.1016/j.bjorl.2015.03.014", "article-title": "Topical therapy with high-volume budesonide nasal irrigations in diffi-cult-to-treat chronic rhinosinusitis", "author": "Kosugi", "doi-asserted-by": "crossref", "first-page": "191", "journal-title": "Braz. J. Otorhinolaryngol.", "key": "ref_120", "volume": "82", "year": "2016" }, { "DOI": "10.1007/s40136-012-0004-3", "article-title": "Reasons for failure in endoscopic sinus surgery", "author": "Graham", "doi-asserted-by": "crossref", "first-page": "45", "journal-title": "Curr. Otorhinolaryngol. Rep.", "key": "ref_121", "volume": "1", "year": "2013" }, { "article-title": "Intranasal corticosteroids for non-allergic rhinitis", "author": "Segboer", "first-page": "CD010592", "journal-title": "Cochrane Database Syst. Rev.", "key": "ref_122", "volume": "2019", "year": "2019" }, { "DOI": "10.1097/00005537-200402000-00004", "article-title": "Comparison of topical medication delivery systems after sinus surgery", "author": "Miller", "doi-asserted-by": "crossref", "first-page": "201", "journal-title": "Laryngoscope", "key": "ref_123", "volume": "114", "year": "2004" }, { "DOI": "10.1007/s00405-024-08535-x", "article-title": "Evaluating the efficacy of nasal irrigation in postoperative functional endoscopic sinus surgery patients: A systematic review and meta-analysis", "author": "Gnanasekaran", "doi-asserted-by": "crossref", "first-page": "3903", "journal-title": "Eur. Arch. Otorhinolaryngol.", "key": "ref_124", "volume": "281", "year": "2024" }, { "DOI": "10.1007/s12070-020-01878-x", "article-title": "The effectiveness of budesonide nasal irrigation after endoscopic sinus surgery in chronic allergic rhinosinusitis with polyps", "author": "Thanneru", "doi-asserted-by": "crossref", "first-page": "350", "journal-title": "Indian J. Otolaryngol. Head Neck Surg.", "key": "ref_125", "volume": "72", "year": "2020" }, { "DOI": "10.1017/S0022215116009269", "article-title": "Hyaluronic acid for post-sinus surgery care: Systematic review and meta-analysis", "author": "Fong", "doi-asserted-by": "crossref", "first-page": "S2", "journal-title": "J. Laryngol. Otol.", "key": "ref_126", "volume": "131", "year": "2017" }, { "DOI": "10.1177/0003489419833714", "article-title": "Environmental Triggers Associated with Empty Nose Syndrome Symptoms: A Cross-Sectional Study", "author": "Manji", "doi-asserted-by": "crossref", "first-page": "601", "journal-title": "Ann. Otol. Rhinol. Laryngol.", "key": "ref_127", "volume": "128", "year": "2019" }, { "DOI": "10.2500/ajra.2011.25.3577", "article-title": "Hyaluronic Acid Gel in the Treatment of Empty Nose Syndrome", "author": "Modrzynski", "doi-asserted-by": "crossref", "first-page": "103", "journal-title": "Am. J. Rhinol. Allergy", "key": "ref_128", "volume": "25", "year": "2011" }, { "DOI": "10.1111/j.1365-2273.1992.tb01679.x", "article-title": "The Role of Mucosal Receptors in the Nasal Sensation of Airflow", "author": "Clarke", "doi-asserted-by": "crossref", "first-page": "383", "journal-title": "Clin. Otolaryngol. Allied Sci.", "key": "ref_129", "volume": "17", "year": "1992" }, { "article-title": "Surgery of the Turbinates and “Empty Nose” Syndrome", "author": "Scheithauer", "first-page": "Doc03", "journal-title": "GMS Curr. Top. Otorhinolaryngol. Head Neck Surg.", "key": "ref_130", "volume": "9", "year": "2010" }, { "DOI": "10.3390/jpm13071160", "doi-asserted-by": "crossref", "key": "ref_131", "unstructured": "Baptista, P., Moffa, A., Giorgi, L., and Casale, M. (2023). Randomized Clinical Trial to Evaluate the Efficacy and Tolerability of Nebulized Hyaluronic Acid and Xylitol Based Solution after Septoturbinoplasty. J. Pers. Med., 13." }, { "DOI": "10.2500/ajra.2012.26.3787", "article-title": "Nasal Irrigation as an Adjunctive Treatment in Allergic Rhinitis: A Systematic Review and Meta-Analysis", "author": "Hermelingmeier", "doi-asserted-by": "crossref", "first-page": "e119", "journal-title": "Am. J. Rhinol. Allergy", "key": "ref_132", "volume": "26", "year": "2012" }, { "article-title": "Saline Irrigation for Allergic Rhinitis", "author": "Head", "first-page": "CD012597", "journal-title": "Cochrane Database Syst. Rev.", "key": "ref_133", "volume": "6", "year": "2018" }, { "DOI": "10.3390/jcm8010064", "doi-asserted-by": "crossref", "key": "ref_134", "unstructured": "Li, C.L., Lin, H.C., Lin, C.Y., and Hsu, T.F. (2019). Effectiveness of Hypertonic Saline Nasal Irrigation for Alleviating Allergic Rhinitis in Children: A Systematic Review and Meta-Analysis. J. Clin. Med., 8." }, { "DOI": "10.1016/j.aller.2020.01.002", "article-title": "Role of Nasal Saline Irrigation in the Treatment of Allergic Rhinitis in Children and Adults: A Systematic Analysis", "author": "Wang", "doi-asserted-by": "crossref", "first-page": "360", "journal-title": "Allergol. Immunopathol.", "key": "ref_135", "volume": "48", "year": "2020" }, { "DOI": "10.1016/j.ijporl.2017.04.040", "article-title": "The Acceptability and Tolerability of Nasal Douching in Children with Allergic Rhinitis: A Systematic Review", "author": "Sands", "doi-asserted-by": "crossref", "first-page": "126", "journal-title": "Int. J. Pediatr. Otorhinolaryngol.", "key": "ref_136", "volume": "98", "year": "2017" }, { "DOI": "10.1177/039463201202500318", "article-title": "Hypertonic Saline Is More Effective Than Normal Saline in Seasonal Allergic Rhinitis in Children", "author": "Marchisio", "doi-asserted-by": "crossref", "first-page": "721", "journal-title": "Int. J. Immunopathol. Pharmacol.", "key": "ref_137", "volume": "25", "year": "2012" }, { "DOI": "10.2500/ajra.2014.28.4066", "article-title": "Isotonic Saline Nasal Irrigation Is an Effective Adjunctive Therapy to Intranasal Corticosteroid Spray in Allergic Rhinitis", "author": "Nguyen", "doi-asserted-by": "crossref", "first-page": "308", "journal-title": "Am. J. Rhinol. Allergy", "key": "ref_138", "volume": "28", "year": "2014" }, { "article-title": "Current Concepts in Topical Therapy for Chronic Sinonasal Disease", "author": "Harvey", "first-page": "217", "journal-title": "J. Otolaryngol. Head Neck Surg.", "key": "ref_139", "volume": "39", "year": "2010" }, { "DOI": "10.1016/0091-6749(94)90346-8", "article-title": "Basophils and eosinophils in allergic rhinitis", "author": "Naclerio", "doi-asserted-by": "crossref", "first-page": "1303", "journal-title": "J. Allergy Clin. Immunol.", "key": "ref_140", "volume": "94", "year": "1994" }, { "article-title": "Treatment of allergic rhinitis with normal saline nasal irrigation at different temperature", "author": "Lin", "first-page": "109", "journal-title": "Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi", "key": "ref_141", "volume": "49", "year": "2014" }, { "DOI": "10.1017/S0022215121000967", "article-title": "Effect of adjunctive sodium hyaluronate versus surfactant nasal irrigation on mucociliary clearance in allergic rhinitis: A single-blind, randomised, controlled study", "author": "Ocak", "doi-asserted-by": "crossref", "first-page": "529", "journal-title": "J. Laryngol. Otol.", "key": "ref_142", "volume": "135", "year": "2021" }, { "DOI": "10.2165/00003495-200363170-00004", "article-title": "Treatment of allergic rhinitis during pregnancy", "author": "Demoly", "doi-asserted-by": "crossref", "first-page": "1813", "journal-title": "Drugs", "key": "ref_143", "volume": "63", "year": "2003" }, { "DOI": "10.1007/s11882-014-0458-0", "article-title": "Diagnosing rhinitis during pregnancy", "author": "Namazy", "doi-asserted-by": "crossref", "first-page": "458", "journal-title": "Curr. Allergy Asthma Rep.", "key": "ref_144", "volume": "14", "year": "2014" }, { "DOI": "10.1002/1096-9926(200012)62:6<385::AID-TERA5>3.0.CO;2-Z", "article-title": "Birth defects after maternal exposure to corticosteroids: Prospective cohort study and metaanalysis of epidemiological studies", "author": "Mazzotta", "doi-asserted-by": "crossref", "first-page": "385", "journal-title": "Teratology", "key": "ref_145", "volume": "62", "year": "2000" }, { "DOI": "10.1093/aje/kws427", "article-title": "Use of decongestants during pregnancy and the risk of birth defects", "author": "Yau", "doi-asserted-by": "crossref", "first-page": "198", "journal-title": "Am. J. Epidemiol.", "key": "ref_146", "volume": "178", "year": "2013" }, { "DOI": "10.1055/s-2007-994110", "article-title": "Pregnancy outcome following first trimester exposure to antihistamines: Meta-analysis", "author": "Seto", "doi-asserted-by": "crossref", "first-page": "119", "journal-title": "Am. J. Perinatol.", "key": "ref_147", "volume": "14", "year": "1997" }, { "DOI": "10.1067/mai.2003.1340", "article-title": "Normal pregnancy outcomes in a population-based study including 2,968 pregnant women exposed to budesonide", "author": "Norjavaara", "doi-asserted-by": "crossref", "first-page": "736", "journal-title": "J. Allergy Clin. Immunol.", "key": "ref_148", "volume": "111", "year": "2003" }, { "DOI": "10.18176/jiaci.0001", "article-title": "The treatment of allergic respiratory disease during pregnancy", "author": "Namazy", "doi-asserted-by": "crossref", "first-page": "1", "journal-title": "J. Investig. Allergol. Clin. Immunol.", "key": "ref_149", "volume": "26", "year": "2016" }, { "DOI": "10.1159/000236003", "article-title": "Nasal lavage in pregnant women with seasonal allergic rhinitis: A randomized study", "author": "Garavello", "doi-asserted-by": "crossref", "first-page": "137", "journal-title": "Int. Arch. Allergy Immunol.", "key": "ref_150", "volume": "151", "year": "2010" }, { "DOI": "10.4193/Rhino12.045", "article-title": "Pregnancy-induced rhinitis", "author": "Orban", "doi-asserted-by": "crossref", "first-page": "111", "journal-title": "Rhinology", "key": "ref_151", "volume": "51", "year": "2013" }, { "DOI": "10.1055/s-2006-951302", "article-title": "Pregnancy-associated rhinitis", "author": "Shushan", "doi-asserted-by": "crossref", "first-page": "431", "journal-title": "Am. J. Perinatol.", "key": "ref_152", "volume": "23", "year": "2006" }, { "DOI": "10.1159/000010223", "article-title": "The incidence of pregnancy rhinitis", "author": "Ellegard", "doi-asserted-by": "crossref", "first-page": "98", "journal-title": "Gynecol. Obstet. Invest.", "key": "ref_153", "volume": "49", "year": "2000" }, { "DOI": "10.1016/j.iac.2005.10.007", "article-title": "Pregnancy rhinitis", "author": "Ellegard", "doi-asserted-by": "crossref", "first-page": "119", "journal-title": "Immunol. Allergy Clin. N. Am.", "key": "ref_154", "volume": "26", "year": "2006" }, { "DOI": "10.1378/chest.117.1.137", "article-title": "Snoring, pregnancy-induced hypertension, and growth retardation of the fetus", "author": "Franklin", "doi-asserted-by": "crossref", "first-page": "137", "journal-title": "Chest", "key": "ref_155", "volume": "117", "year": "2000" }, { "DOI": "10.1001/archotol.124.4.439", "article-title": "Serum level of placental growth hormone is raised in pregnancy rhinitis", "author": "Oscarsson", "doi-asserted-by": "crossref", "first-page": "439", "journal-title": "Arch. Otolaryngol. Head Neck Surg.", "key": "ref_156", "volume": "124", "year": "1998" }, { "DOI": "10.1159/000023904", "article-title": "Expression of histamine receptors in nasal epithelial cells and endothelial cells–the effect of sex hormones", "author": "Hamano", "doi-asserted-by": "crossref", "first-page": "220", "journal-title": "Int. Arch. Allergy Appl. Immunol.", "key": "ref_157", "volume": "115", "year": "1998" }, { "DOI": "10.1016/S0095-5108(18)30173-8", "article-title": "Asthma and allergy in pregnancy", "author": "Schatz", "doi-asserted-by": "crossref", "first-page": "407", "journal-title": "Clin. Perinatol.", "key": "ref_158", "volume": "24", "year": "1997" }, { "DOI": "10.1111/j.1651-2227.2008.00762.x", "article-title": "Assessment of foetal exposure to cigarette smoke after recent implementations of smoke-free policy in Italy", "author": "Franchini", "doi-asserted-by": "crossref", "first-page": "546", "journal-title": "Acta Paediatr.", "key": "ref_159", "volume": "97", "year": "2008" }, { "DOI": "10.1016/j.jaip.2017.10.003", "article-title": "Home environmental interventions for house dust mite", "author": "Wilson", "doi-asserted-by": "crossref", "first-page": "1", "journal-title": "J. Allergy Clin. Immunol. Pract.", "key": "ref_160", "volume": "6", "year": "2018" }, { "DOI": "10.1016/j.bjorl.2015.04.011", "article-title": "Rhinitis and pregnancy: Literature review", "author": "Caparroz", "doi-asserted-by": "crossref", "first-page": "105", "journal-title": "Braz. J. Otorhinolaryngol.", "key": "ref_161", "volume": "82", "year": "2016" }, { "DOI": "10.1177/019459988809900604", "article-title": "Eustachian tube and nasal function during pregnancy: A prospective study", "author": "Derkay", "doi-asserted-by": "crossref", "first-page": "558", "journal-title": "Otolaryngol. Head Neck Surg.", "key": "ref_162", "volume": "99", "year": "1988" }, { "DOI": "10.1111/j.1745-7599.2002.tb00086.x", "article-title": "Pregnancy rhinitis and rhinitis medicamentosa", "author": "Rabmurg", "doi-asserted-by": "crossref", "first-page": "527", "journal-title": "J. Am. Acad. Nurse Pract.", "key": "ref_163", "volume": "14", "year": "2002" }, { "DOI": "10.1016/j.anl.2022.01.014", "article-title": "Medical management of rhinitis in pregnancy", "author": "Gupta", "doi-asserted-by": "crossref", "first-page": "905", "journal-title": "Auris Nasus Larynx", "key": "ref_164", "volume": "49", "year": "2022" }, { "article-title": "The prescribing patterns of Wisconsin family physicians surrounding saline nasal irrigation for upper respiratory conditions", "author": "Rabago", "first-page": "145", "journal-title": "WMJ", "key": "ref_165", "volume": "108", "year": "2009" }, { "DOI": "10.1016/j.anai.2012.04.019", "article-title": "Is nasal saline irrigation all it is cracked up to be?", "author": "Khianey", "doi-asserted-by": "crossref", "first-page": "20", "journal-title": "Ann. Allergy Asthma Immunol.", "key": "ref_166", "volume": "109", "year": "2012" } ], "reference-count": 166, "references-count": 166, "relation": {}, "resource": { "primary": { "URL": "https://www.mdpi.com/1648-9144/61/8/1402" } }, "score": 1, "short-title": [], "source": "Crossref", "subject": [], "subtitle": [], "title": "Nasal Irrigations: A 360-Degree View in Clinical Practice", "type": "journal-article", "volume": "61" }