Summary
This study used computational fluid dynamics to compare the effectiveness of using a Neti Pot versus a squeeze bottle for nasal saline irrigation, finding that the Neti Pot provided better coverage in the paranasal sinuses but at the expense of reduced flow and shearing rates, while the squeeze bottle provided greater surface coverage on the side of irrigation.
Key points
- Neti Pot irrigation is more effective in delivering saline solution to the nasal cavity on the contralateral side of irrigation due to typically larger volumes but at the expense of reduced flow and shearing rates.
- Squeeze bottle irrigation provided greater surface coverage on the side of irrigation.
- The Neti Pot increased surface coverage in the paranasal sinuses.
- Reducing the jet diameter may aid the direct targeting of a specific region at the side of irrigation by preventing the impingement of the jet to the nasal passage surface and redirection of the flow.
Highlights
Computational fluid dynamics was used to study nasal irrigation in a healthy patient (opens in a new tab) using different delivery devices.
Ansys Fluent 2021R1 was used to perform a transient multiphase flow simulation.
Squeeze bottle irrigation profile was obtained from physical experiments.
A Neti Pot device was attached to the nostril to represent the irrigation event using a gravity-dependent device.
Abstract
Background and objective: Nasal saline irrigation is a common therapy for inflammatory nasal and paranasal disease or for managing post nasal and sinus surgery (opens in a new tab) recovery. Two common irrigation devices include the netipot and squeeze bottles, where anecdotally, these devices alleviate congestion (opens in a new tab), facial pain, and pressure. However, a quantitative evaluation (opens in a new tab) of these devices’ performance and the fluid dynamics responsible for the irrigation distribution through the nose is lacking. This study tracked the liquid surface coverage and wall shear stresses (opens in a new tab) during nasal saline irrigation produced from a Neti Pot and squeeze bottle.
Methods: This study used transient computational fluid dynamics (CFD) simulations to investigate the saline irrigation flow field in a subject-specific sinonasal model. The computational nasal cavity (opens in a new tab) model was constructed from a high-resolution computed tomography scan (opens in a new tab) (CT). The irrigation procedure applied a head position tilted at 90° forward using an 80 ml squeeze bottle and 120 ml Neti Pot.
Results: The results from a single sinonasal model demonstrated that the Neti Pot irrigation was more effective in delivering saline solution to the nasal cavity on the contralateral (opens in a new tab) side of irrigation due to typically larger volumes but at the expense of reduced flow and shearing rates, as the flow entered under gravitational forces (opens in a new tab). The squeeze bottle irrigation provided greater surface coverage on the side of irrigation.
Conclusions: The results from the single patient model, demonstrated the Neti Pot increased surface coverage in the paranasal sinuses (opens in a new tab). Reducing the jet diameter may aid the direct targeting of a specific region at the side of irrigation by preventing the impingement of the jet to the nasal passage surface and redirection of the flow. Evaluating this performance across a wider cohort of patients can strengthen the findings.
Keywords
Nasal cavity
CFD
Neti pot
Nasal saline irrigation
Paranasal sinuses