Nasal Irrigation in Children: From Pathophysiological Rationale to Clinical Practice

Area of Science:

• Pediatric Otolaryngology
• Respiratory Medicine
• Immunology

Background:

• Upper respiratory infections and inflammatory nasal disorders are common in children.
• Nasal mucosa defenses can be compromised by inflammation, pollutants, and mucociliary dysfunction.
• This increases susceptibility to infections and airway inflammation.

Purpose of the Study:

• To provide an updated overview of nasal irrigation (NI) in pediatric populations.
• To integrate pathophysiological mechanisms with NI's role in childhood respiratory diseases.
• To discuss clinical indications, techniques, and safety of NI for children.

Main Methods:

• This is a narrative review.
• It integrates knowledge on mucociliary dysfunction, environmental exposures, and pediatric anatomy/physiology.
• Focus is on understanding NI's role in pediatric upper airway diseases.

Main Results:

• Nasal irrigation mechanically removes mucus, pathogens, allergens, and inflammatory mediators.
• NI improves mucociliary clearance, mucus rheology, and epithelial barrier function.
• Hypertonic solutions may offer additional osmotic and decongestant benefits.

Conclusions:

• Nasal irrigation is a safe and well-tolerated adjunctive intervention for pediatric upper airway diseases.
• It may improve symptoms and support mucosal function.
• Appropriate technique, caregiver education, and hygiene are crucial for effective NI.