Contamination of sinus irrigation devices: a review of the evidence and clinical relevance.
BACKGROUND
The use of saline and topical medications in the treatment of chronic rhinosinusitis (CRS) is now common practice among otolaryngologists. Although high-level studies have consistently shown the benefit of saline in symptom improvement of CRS patients, to date, only lower-level evidence exists advocating a benefit of other topical medications.


METHODS
Recently, increased interest has emerged surrounding the devices used to deliver such therapies with mounting evidence consistently showing contamination with pathogenic organisms such as Staphylococcus aureus and Pseudomonas aeruginosa.


RESULTS
In addition, the potential for such contamination to cross-infect sinus cavities and lead to postoperative infections is also of concern.


CONCLUSIONS
This review examines the current evidence available concerning the issue of contamination and its clinical relevance and offers the otolaryngologist advice on patient education when dispensing such devices.
Department of Otolaryngology Head and Neck Surgery, Medical University of South Carolina, Charleston, 29425-5500, USA. alkispsaltis@gmail.com
Alkis J
AJ
Psaltis
Andrew
A
Foreman
Peter-John
PJ
Wormald
Rodney J
RJ
Schlosser
D001424:Bacterial Infections / Q000209:etiology / Q000517:prevention & control; D002908:Chronic Disease; D004866:Equipment Contamination; D006801:Humans; D055556:Nasal Lavage / Q000295:instrumentation*; D010256:Paranasal Sinuses / Q000382:microbiology; D010353:Patient Education as Topic; D011550:Pseudomonas aeruginosa; D012220:Rhinitis / Q000628:therapy*; D012852:Sinusitis / Q000628:therapy*; D013211:Staphylococcus aureus