Published Medical Reports

Published Medical Reports

Our work on pulsatile irrigation and specifically nasal irrigation dates back nearly 40 years with published medical reports dating back even further. As the original pioneer of pulsatile nasal sinus irrigation we introduced the first FDA registered pulsatile nasal irrigator and is now a worldwide sensation used by millions of allergy and sinus sufferers worldwide.

General Articles on Pulsatile Nasal Irrigation & Sinusitis

Having Nasal Surgery? Don’t You Become An Empty Nose Victim, Christopher Martin. 2008.

Sinus Relief Now: The Ground-Breaking 5-Step Program for Sinus, Allergy, and Asthma Sufferers by Jordan S. Josephson, 2007

The Sinus Cure by Debra Bruce and Murray Grossan. 2007.

Harvard Medical School Guide to Healing Your Sinuses (Harvard Medical School Guides) by Ralph Metson and Steven Mardon, 2006

Patients at the Nasal Dysfunction Clinic an Univ. of Cal. San Diego had excellent relief by daily irrigation with pulsatile irrigation for sinusitis, perennial allergy, seasonal allergy, postnasal drip, and associated fatigue. Very well accepted by patients.Clinical Study and Literature Review of Nasal Irrigation, Davidson, T., Laryngoscope 110: July 00

"[Pulsatile] Nasal Irrigation with salt water is extremely helpful for flushing infected sinuses or cleansing the membranes of the nose and sinuses." The Complete Self-Care Guide to Holistic Medicine, Robert Ivker 1999

Management of Sinusitis: Current Clinical Strategies,"If the patient has recurrent disease a pulsatile irrigator is.particularly effective after surgery." page 121, "Treatment of Chronic Sinusitis - Nasal washing ...applied through the Pulsatile irrigator and [nasal] adapter twice a day is recommended. Michael Kaliner MD and David W Kenned, MD, in Sinusits Disease Management Guide. PDR 2000

Therapeutic Agents In The Medical Management Of Sinusitis, Not only is the [pulsatile] Sinus Irrigator beneficial for patients with bothersome thick postnasal secretions, but is especially helpful for postoperative cleansing following nasal surgery. Mabry, R.L. In: Inflammatory diseases of the sinuses. Otolaryngologic Clinics Of North America, Volume 26, Number 4, pp 561, 1993.

Sinusitis: Acute, Chronic and Mangegeable,"A particularly helpful strategy is saline washing using a Pulsatile irrigator. Sinus irrigator is so effective in clearing the blocked passages that , if it is done regularly, some patients with persisitent or chronic sinusitis need no drug treatment at all. Rachelevsky G S, Slavin R G et all. Patient Care. Feb 28, 1997 Vol 131:4.

A Device for Nasal Irrigation, An easy method of sinus treatment at home or office. With this device the patient can leave the office with the bacterial load reduced, hence requires less antibiotic and much greater patient satisfaction. Grossan M Transactions of the American Academy of Ophthalmology and Otolaryngology. 78: July 1974 279-280

Sinusitis: Bench to Bedside, Pulsatile sinus irrigation is recommended as a treatment for sinusitis, and as a supplement to other treatment modalities. Kaliner MA et al. Otolaryngology June 97 116:6 Part 2 Study of Sinusits.

A New Nasal Irrigator Device. Application of pulsatile irrigation for post nasal drip and phlegm. Grossan M. The Eye, Ear Nose And Throat Monthly. March 1974

A Device To Aid Nasal Mucociliary Flow, In Japan there is a very high incidence of sinusitis requiring surgery. Pulsatile irrigation is helpful to avoid surgery. Grossan A.N.L. March 1976 pp 65-70.

Office Measurement of Nasal Mucociliary Clearance, The saccharin test is an objective measure of one very important aspect of the respiratory defense system. Many diagnostic dilemmas are solved using this test. The nasal test reflects the chest condition. Using pulsatile irrigation, one can improve both. Grossan, M. English: Otolaryngology 1994 Vol 2 ch 7

Treatment of Sinusitis in the Next Millennium, Saline irrigation using a pulsating stream and sinus adaptor is an effective non-drug treatment for sinusitis. Kaliner, M. Allergy and Asthma Proceedings, 19:181-4, 1998

Nasal Hyperthermia and Simple Saline Irrigation for Perennial Rhinitis, Changes in Inflammatory Mediators,  Saline irrigation with pulsatile irrigator significantly the presence of mediatiores of inflammation in the nasal exudate six hours after treatment. Georgitis JW. Chest 106:1487 - 82, 1994

Pulsating irrigation is shown to remove pus and allow for natural, holistic healing. Sinus Survival, Ivker R., Putman Publication 1995.

A Device for Nasal Irrigation, Nasal irrigation is found to be an easy method of sinus treatment at home or office. With this device the patient can leave the office with the bacterial load reduced, hence requiring less antibiotic and producing greater patient satisfaction. Grossan, M. Transactions of the American Academy of Ophthalmology and Otolaryngology. 78: July 1974 279-280.

Pulsation Irrigation: a Simple, Safe Effective Treatment of Many Nasal Complaints, Pulsatile nasal irrigation is recommended as a simple safe treatment for many sinus, ear and allergy complaints. High patient acceptance and enthusiasm is reported. Pope, A., O.R.L. Digest August 1974 15:8 pp 3638.

A New Nasal Irrigator Device, Application of pulsatile irrigation for post nasal drip and phlegm is described. Grossan, M., The Eye, Ear Nose and Throat Monthly, March 1974.

Pulsatile Nasal Irrigation in Children

Pediatric sinusitis, Pulsatile irrigation works for children, even without antibiotics.Manning, Scott, C., Inflammatory Diseases of the Sinuses. Otolaryngologic Clinics of North America. Volume 26, Number 4, pp 623-638 (1993).

Irrigation of the Child's Nose, Children with sinusitis, post nasal drip or nasal blockage use pulsatile nasal irrigation at age 5 or older. By removing discharge, adenoid and tonsil hypertrophy were reduced. Irrigation was also found to be an aid to clearing the ear. Grossan, M., Clinical Pediatrics, March 1974 13:3 229-231.


Geriatric Rhinitis: What it is, how to treat it. Pulsed irrigation of nasal passages may be performed using a [pulsating] device equipped with the nasal tip applicator. Jennifer A Jordan, Geriatrics: June 98.

Rhinitis and Nasal Obstruction, The Pulsatile irrigation device is an efficient system for irrigation . The irrigant is instilled as a pulsating stream into one nasal cavity and drains out through the other side. [Pulsatile irrigation] effectively loosens crusts. Lucente, F.E. In: Nasal Obstruction. Otolaryngologic Clinics Of North America, Volume 22, Number 2, pp 307, 1989.

Atrophic Rhinitis, Atrophic rhinitis varies in severity and is difficult to cure. Dr Goodman recommends Pulsatile irrigation for symptomatic relief and treatment. Goodman, Wilfred S. English: Otolaryngology Vol 2 Ch. 14 1984

Medical Management of Rhinitis, The principal benefits from pulsatile irrigation include: 1. Augments mucociliary flow 2 Liquefies tenacious mucus 3. Soothes irritated tissues 4. Removes crusts and microforeign bodies 5. Augments tissue repair 6. Reduces forceful nose blowing 7. Improves olfaction. Fadal R. English: Otolaryngology Vol 2:Ch 13

Chronic Rhinitis, a Practical Approach to Diagnosis And Treatment. Good allergy management includes use of irrigation for removal of offending particles and restoring normal ciliary flow.  Zeigler, R. Shatz , M Part 2 Treatment. Immunology, Allergy Practice 1982. 4:3 pp 26-36

Allergic or Non Allergic Rhinitis, It has been shown in many patients with chronic rhinitis that mucociliary transport is markedly increased after two weeks of one or two times a day irrigation using the pulsatile irrigator. Meltzer EO, In Allergy: Principles and Practice, editors: Middleton and Reed. Vol 2 pp 1181, 1992 

Rhinitis, Allergy: All forms of allergy rhinitis are benefitted by saline irrigation with the pulsatile irrigator. Principles and Practice, 3rd edition. Middleton E. CV Mosby Company Ch 17, 1988 

Atrophic Rhinitis, The pulsatile irrigator is shown to increase the efficiency of saline nasal douches. deSouza, F.M.: Chapter 14N English: Otolaryngology 1996.

Atrophic Rhinitis, Atrophic rhinitis varies in severity and is difficult to cure. Pulsatile irrigation is recommended for symptomatic relief and treatment. Goodman, Wilfred S., Otolaryngology Vol 2 Ch. 14 1984.

Chronic Rhinitis, A Practical Approach to Diagnosis and Treatment. Good allergy management is shown to include irrigation for removal of offending particles in order to restore normal ciliary flow. Zeigler, R. Shatz , M Part 2 Treatment. Immunology, Allergy Practice 1982. 4:3 pp 26-36.


Sinusitis and Bronchial Asthma, Slavin presents three mechanisms re sinusitis causing asthma. Clearing sinusitis is important in asthma. Slavin RG: J Allergy and Clinical Immunol 66:250-257, 1980

Allergies and Asthma for Dummies "Use a pulsatile irrigator to irrigate with warm saline solution to relieve pressure and congestion in your nasal passages "  William E Berger, MD


Inhibition Of The Seasonal Ige Increase To Dactylis Glomerata By Daily Saline Nasal - Sinus Irrigation During The Grass Pollen Season, pulsatile irrigation works for allergy by removing the IgE so that the pollen doesn't cause symptoms. Journal of Allergy and Clinical Immunology. In press

Allergies and Asthma for Dummies by William E Berger, MD - see above in Asthma [Pulsatile] Irrigation is recommended for nasal problems. Current Review of Allergic Diseases 2001 edited by Michael A Kaliner

Prospects for ancillary treatment of rhinosinusitis in the 1990's, Recommends pulsatile irrigation to reduce or eliminate allergy symptoms. Zeiger RS. , J Allergy Clin Immunol 1992;90:478-495

Post-Operative Care

Perioperative Care in Functional Endoscopic Sinus Surgery, Pulsatile irrigation should be done 1 to 3 times a day postoperatively until no further benefit is achieved. Sonkens JW, Miller R.J. Highlilghts of the Instructional Course. Ed Lucente, editor Chapter 24. pp267-277

Endoscopic Paranasal Sinus Surgery, Pulsatile irrigation before sinus surgery is recommended to reduce infection and after surgery to restore ciliary function and reduce patient's symptoms. Rice, D., Ravens Press 1993. 

Rhinoplasty, four days after nasal surgery start to use the pulsatile Irrigator . Almost all patients find the cleaning provided by pulsatile irrigation a great source of comfort. It significantly improves mucociliary transport in the first few weeks postoperatively. Edited by Rolin K Daniel, M.D. 1993 Chapter 2 by Geroge Meredith.

Evaluation of methods of Sinus Nasal Irrigation Irrigation Post Sinus Surgery. "Pulsatile Irrigation is the preferred method of treatment after endoscopic surgery. Highly accepted by patients. Cenjor, C. Gutierrez, R. Congress of Spanish Society of Otolaryngology and Cervical Facial Pathology. Las Palmas de Gran canaria, 12- 16 Octubre de 1998

Fungus Infection

Effect of anti-fungal nasal lavage with amphotericin B on nasal polyposis. Recent studies have suggested that allergic fungal rhino-sinusitis could be involved in the development of nasal polyposis. The aim of this study was to evaluate the response of anti-fungal nasal lavages. Patients performed nasal lavage with 20 ml of a one per one thousand amphotericin B suspension in each nostril, twice a day, for four weeks. In addition, all patients continued their saline nasal lavage and their conventional topical corticosteroid spray.

This study included 74 patients, with a mean age of 46 years (range from 19 to 73). Before anti-fungal treatment, the distribution of nasal polyposis, according to Malm, was: 13 patients in stage I (17.5 per cent), 48 patients in stage II (65 per cent) and 13 patients in stage III (17.5 per cent). After anti-fungal nasal lavages, the total disappearance of nasal polyposis was observed in 29 patients (39 per cent). Eight patients were stage I, 21 stage II, and none stage III. In patients who have had previous endoscopic polypectomy and functional endoscopic sinus surgery, total disappearance of nasal polyposis was seen in 24 patients (47 percent). Hyper-reactivity to fungal organisms could be one of the mechanisms underlying the development of nasal polyposis. A direct effect of amphotericin B suspension on the integrity of the cell membrane of the polyps' epithelium could not be excluded. Ricchetti A, Landis BN, Maffioli A, Giger R, Zeng C, Lacroix JS.J Laryngol Otol 2002 Apr;116(4):261-3 Rhinology Unit, Department of Otorhinolaryngology - Head and Neck Surgery, Geneva University Hospital, Switzerland.

Effects of Aspergilis fumigatus and Alternaria on human ciliated epithelium in vitro. Nasal cilia are inhibited by toxins from Fungi. Inhibition of the cilia can reduce the effectiveness of natural healing. Cody,DT 2nd,Mcaffrey, TV. Kern,E Laryngoscope.1997. Nov:107 1511-4

Cystic Fibrosis

Management Of Sinusitis In Cystic Fibrosis, Stresses the use of pulsatile irrigator for home use. Recommends antibiotic irrigation of sinuses. Moss RB, King W. . Arch Otolaryngol Head Neck Surg. 1995;1 21:566-572.

Pulsatile irrigator: Irrigation with [Nasal] Adaptor is used for CF, pulsatile sinus irrigation makes an ideal vehicle for local administration of antibiotics and other products. Cystic Fibrosis Currents Volume 11, No 4 Method For Rapid Evaluation Of Topical Of Topically Applied Agents To Cystic Fibrosis, Wine JJ, King W, Lewiston NJ Am J Physiol. 1991261 (Lung Cell Mol Physiol. 5):L21 8-L221

Management of Chronic Sinusitis in Cystic Fibrosis,Cystic fibrosis is commonly associated with sinusitis due to mucociliary system failure. Patients may benefit by lung transplant. Pre-op pulsatile saline irrigation is found to be a successful means of clearing the sinus of disease.  Davidson, T., Laryngoscope 105:354 April 1995.

Ciliary Function & Mucociliary Clearance

Mucociliary Clearance and Buffered Hypertonic Saline Solution, Stresses the importance of saline irrigation for Mucociliary Clearance for patients with acute and chronic sinusitis, and post operative functional endoscopic sinus surgery. Finds close correlation with the saccharin test to other methods of measurement. Talbot A, et al Laryngoscope 107:April 1997

Coughing, wheezing, respiratory complaints may be significantly benefited by use of the pulsatile saline irrigator. Removing pus from the sinus via simple irrigation can significantly speed healing and prevent spread of infection from the sinus to the lungs. Daily removal of pus by the patient at home is beneficial. Enhancing The Mucociliary System, Grossan, M. Advances for respiratory care practitioners.. April 17, 1995 8 pp12-13

Sinusitis: Complications And Sequelae: An Otolaryngologist's Perspective, Shows that radiographic material placed in the nose before bedtime is found in the tracheobronchial tree in the morning. Thus sinus secretions can contaminate the tracheobronchial tree causing infection and bronchospasm. Hence the value of irrigation to remove offending material. Fairbanks, D.N.F.: Pediatr Infect Dis J 4 (Suppl 6) 875-878 1995

Evaluation of methods of Sinus Nasal Irrigation Irrigation Post Sinus Surgery, Pulsatile irrigation with is the preferred method of treatment after endoscopic surgery. Highly accepted by patients. Cenjor, C. Gutierrez, R. Congress of Spanish Society of Otolaryngology and Cervical Facial Pathology. Las Palmas de Gran canaria, 12- 16 Octubre de 1998 

The saccharin test is shown to be an objective measure of one very important aspect of the respiratory defense system. Many diagnostic dilemmas are solved using this test. The nasal test reflects the chest condition. Using pulsatile irrigation, one can therefore improve both chest and sinus problems. Office Measurement of Nasal Mucociliary Clearance, Grossan, M., English: Otolaryngology 1994 Vol 2 ch 7. 

Ciliary Beating Frequency in Chronic Sinusitis, After diseased mucosa is cleared of thick mucus and bacteria, ciliary function is shown to return. Nuutinen J, Arch Otolaryngol Head Neck Surg 119:645, 1993.

Mucociliary Flow in Otolaryngology Practice, Many noxious exposures can inactivate mucociliary clearance, including smog, exhaust fumes, chlorine, chromium, etc. The sooner normal ciliary activity is restored, the sooner the natural physiology of the defense system can ward off illness. Hot tea, chicken soup, iodides, and pulsatile irrigation are shown to be important aids to the natural defense system. Grossan M., Insights in Otolaryngology. August 1993 8 :2-8. 

The Saccharin Test of Nasal Mucociliary Function, An objective test of mucociliary clearance is described. This test is useful for measuring cilia function before and after pulsatile nasal irrigation to objectify degree of improvement. Grossan, M., Eye, Ear, Nose and Throat Monthly 1975 54:(11), pp 415-417.

Nasal Mucociliary Flow - A Clinical View, Grossan, M., Amer Acad of Otol and Ophth Scientific Presentation Dallas 1975 (certificate of merit award).

Irrigation Fluid & Salinity

Classification of Cilio-Inhibiting Effects of Nasal Drugs. Paul Merkus. Laryngoscpe: 111 April 2001 pp595 - 601

Use of Locke-Ringer's formula is best for enhancing cilia. On a 1-100 scale, Locke-Ringer's is 100. Physiologic and Hypertonic Saline Solutions Impair Ciliary Activity in Vitro. Certain hypertonic saline solutions cause ciliostasis (the cilia stop functioning) from which the cilia may not recover. If cilia are permanently damaged, the ability to fight infection is lost.  Boeck,Wilbert. Keles, Nesil. Graamans, Kees, Laryngoscope March 99 No 3, p.396.

Ringer-Lactate solution versus isotonic saline solution on mucociliary function after nasal septal surgery.Irrigation with isotonic saline is one of the most frequently used solutions after nasal surgery. However, the effect of saline solutions on mucociliary clearance is not well known. In a previous study, it was found that isotonic saline solution had a negative effect on ciliary beat frequency but Ringer-Locke solution had no effect in vitro. In this study we compared the effects of Ringer-Lactate solution and isotonic saline solution on mucociliary transport time before, and after, nasal septal surgery in patients with nasal septal deviation. We found that patients who used Ringer-Lactate solution as irrigation after surgery had a significantly better mucociliary transport time than the patients using isotonic saline solution (p < 0.05). In conclusion, it is better to use Ringer-Lactate solution instead of 0.9 per cent saline solution for nasal irrigation. (Breathe.ease XL is a modified Ringer —Lactate product) Unal M, Gorur K, Ozcan C.J Laryngol Otol 2001 Oct;115(10):796-7

Pulsatile Action

The efficacy of pulsatile saline irrigation has been demonstrated in orthopedics, surgery and dental literature too. Using Pulsatile Pressure Saline/Antibiotic Irrigation, Betts N. et al. Compendium Contin Educa Dent, 17(9): 871 1996.

Comparison with pulsatile irrigation versus bulb syringe - only pulsatile irrigation about significant reduction of bacteria. Conclusion: pulsatile irrigation removed bacteria from experimental wounds more efficiently than conventional procedures. Evaluation Of Wound Irrigation By Pulsatile Jet And Conventional Methods, Brown LL; Shelton HT. Ann Surg. 1978 Feb, 187:2, 170-3

In an orthopedic research project, it is shown that pulsatile irrigation is 100x more effective in removing bacteria from a site than simple irrigation, and is even more effective than some antibiotic solutions in tests for clearing infection. The Efficacy of Various Irrigation Solutions in Removing Slime Producing Staphylococcus, Anglen, J. J., Orthop Trauma 1994 Oct;8(5):390-6.

Pulsatile Irrigation of the Throat

Throat irrigation is shown to significantly reduce the need for antibiotics, and to possibly reverse the need for tonsillectomy. It is also shown to be specifically valuable to prevent the spread of infection within the family. A Mechanical Throat Irrigator, Grossan, M., Transactions of the American Academy of Ophthalmology and Otolaryngology. 77: January 1973.

A method to replace gargling is presented that is safe and pleasant. Gargling may cause laryngitis and has been shown to be ineffective. An Instrument for Throat Irrigation, Grossan, M., The O.R.L. Digest July 1972 39:7 pp10-13.

Irrigation of the throat is shown to bring blood to the area, encourage lymphatic drainage, and remove bacteria on the surface and in the crypts.Irrigation  Treatment of Throat Infections, Grossan, M, The Eye, Ear, Nose and Throat Monthly. August 1972 51:8 pp302-305.