These have been suggested as useful both orally as well as a nasal spray. The nasal spray is made by mixing Singulair with Ocean and using this as a treatment for polyps and possibly sinusitis. Some doctors have used a combination of antileukotriene agents such as Zyflo and Singulair.
Dr. Grossan has developed a pulsatile irrigation technique using the Grossan nasal irrigator and Hydropulse, which many people find helpful. This replaces the WaterPik which was used previously. (You can order it from Dr. Grossan's website or from your pharmacist.) Some people also use a neti pot which looks like a small teapot. A simple irrigation bottle has been developed called Sinus Rinse. Another device which has been found useful is the Nasaline irrigator. Irrigation with ENT sol, Sinucleanse, BreathEase XL ( also developed by Dr. Grossan and which can be used in the Hydropulse irrigator), Saltaire ( containing a concentrated salt solution), and salt water (some people may need to use non-iodized or kosher salt with baking soda to reduce burning) can be helpful. Another delivery system has been developed called the Nasopure Nasal Rinse Kit. There are also several other types of irrigation devices. You should check with your doctor and pharmacist about which one to use. You should be aware that there is a danger of contamination of a device with bacteria from your nose if there is no mechanism to prevent backflow from your now into the device. This can occur with any device which does not create a positive pressure ( like the Grossan hydropulse). Please also make sure that you clean the device as suggested and not use tap water.
Antibiotics or antifungal agents by irrigation have been found helpful in some patients. Steroid irrigation using an implanted catheter has helped some patients. Sinuneb has been developed by Sinus Pharmacy for nebulization of antibiotics. A similar device call SinusAero has also been developed. A new device which can be implanted in the nose called the Propel nasal device can be placed at the time of surgery and contained a steroid which is released slowly. There are also products containing Xylitol which may be helpful in preventing bacteria from attaching to the lining and therefore preventing infection. It is contained in BreathEase XL and Xlear. A salt solution called Oasis containing a solution of Dead Sea salts has been found to be helpful to patients with sinusitis and has an anti-inflammatory effect and may also be antifungal as well It is available in both a spray and irrigation formula. Sterimar is a salt water product for irrigation made from sea water. Some people find a preservative free contact lens solution such as Unisol helpful for irrigation.
Ringers lactate has been suggested for irrigation as being less toxic to the nasal mucosa than other nasal irrigations.
Saline nasal sprays including Ayr, Ocean, Salinex, Oasis, Pretz, Rhinaris ( contains propylene glycol, a wetting agent), Ponaris, as well as store brands have been helpful for moisturizing the nose. It is also possible to make up your own. NasoVisc has been suggested for use in patients with a dry nose. BreatheZen is an herbal nasal spray in a buffered saline solution. There is one spray sold called SinoFresh which contains glycerin, saline and has antibacterial and antifungal properties. Capsaicin has also been used by some with help, but watch out because it is the agent in peppers which makes them hot. Some people find pine oil, eucalyptus or Vicks VapoRub helpful. Just don't put the Vicks in your nose. It can cause a pneumonia if it gets in your lungs.
Several of the companies make gels including Ayr, Nose Better, Beroleum, Breath-ease and Nasal Moist. Various topical agents have been found helpful by some including Bactroban, Neomycin, Neosporin, Colace in Ocean, and estrogen cream. Hydrogen peroxide and Betadine applied topically have been found helpful by some. Alkalol is available from your pharmacy's distributor or The Alkalol Company, Taunton, Mass. Entertainer's Secret Spray is sometimes helpful and is available from 1 800 308 7452.
Antiinflammatory drugs such as aspirin, and ibuprofen can be helpful in some patients who are not allergic to them. Likewise the newer COX-2 inhibitors such as Celebrex, which are available by prescription, may be helpful. You should check with your doctor,, however since cardiac problems have been associated with some antiinflammatory drugs.
Hot air inhalation has been reported as helpful to some patients, but studies have shown variable results.
A variety of devices have been developed which mechanically keep the nose open. The Breathe Right is one that is well known that looks like a Band-Aid which fits over the nose and opens the nose up because of an embedded spring inside the Breathe Right. Another is a paper clip like device which fits in the nose which some patients find is helpful in keeping the nose open. It is available from your pharmacy or Breath with Eez Corp, 315 Liberty Avenue, Brooklyn, NY, 718 498 5568. A similar device is the nosebrace, available through your doctor or 1-800-284-6673.Another is a hard silicone device called Quiet Night which fits in the nose and works like the Breathe Right but goes inside the nose. It is available from Hood Laboratories at 1-781-826-7573. Sinus cones are also available from Sanostec. Another device which also looks like a bent paper clip is Noseworks. It is meant to open the nose so that it is easier to breath. We usually suggest that patients try all of the above mechanical devices.
Another device is the Sinu-klean which is an electronic device which applies a small amount of electrical current on the skin over the sinuses. It has been suggested as being helpful by the manufacturer but is not approved by the FDA. It is available from Comtrad Industries 1-800-704-1209.
Papaya enzymes are sometimes found helpful. Dr. Grossan developed a product called Clearease containing papaya and other enzymes which some patients have found helpful.
Herbs and other Chinese remedies
A variety of herbal remedies have been used including Echinacea, horseradish, Bromelain, Goldenseal, Stinging Nettle, ephedra, Chinese Herbs, and homeopathic remedies. They have not been proven in most cases. Some people find chicken soup helpful. Acupuncture has also been found to be helpful for some
Astelin and Patanase are antihistamine nasal sprays which have anti-inflammatory properties which can be helpful, but they can sometimes cause drowsiness and some patients find have an unpleasant taste. Atrovent nasal spray may dry up mucus, but can sometimes be too drying. Furosemide, a diuretic, has also been used as a nasal spray for polyps and sinusitis.
Last updated January 15, 2012
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