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. Conclusion: 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.