[Nasal irrigation in clinical practice: therapeutic innovations]

Rhinitis is an extremely common disease, to the extent that it actually affects the entire population throughout its lifetime. Rhinitis can be classified according to the etiopathogenetic mechanisms involved. Regarding the cause, rhinitis can be infectious, allergic, non-allergic, secondary to other diseases and iatrogenic. In clinical practice, two main pathophysiological mechanisms cause an alteration in nasal physiology: nasal obstruction and mucus overproduction. Nasal obstruction can be due to two main causes, which are acute infection and allergy. Topical nasal therapy is the safest and most effective modality to rapidly achieve normal nasal patency. In particular, the paradigmatic modality of local therapy is nasal lavage, better defined as nasal irrigation. Nasal irrigation is an actual washing of the nasal cavity to remove excess mucus, inflammatory cells, mediators, cytokines, pathogens and all harmful substances. A recent Intersocietal Delphi Consensus was conducted in order to reach agreement on several aspects of topical nasal therapies. In this regard, a recent randomized controlled trial showed that a product containing PEG, bicarbonates and sodium chloride, administered to a group of patients with rhinitis or rhinosinusitis through a squeezable bottle was able to significantly reduce the intensity of symptoms and their impact on daily life. In conclusion, nasal irrigation can be considered a valid treatment option in the management of upper airway disorders. At the same time, it is important that more physicians become aware of the usefulness of this therapeutic method.