Evaluation of a gravity-driven automated nasal irrigation system compared with manual syringe irrigation: a randomized crossover trial

Pichanon Wacharaprapapong; Prapasri Kulalert; Patcharaporn Punyashthira; Orapan Poachanukoon; Paskorn Sritipsukho; Sira Nanthapisal

doi:10.18203/issn.2454-5929.ijohns20260003

Authors

Pichanon Wacharaprapapong Department of Pediatrics, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand
Prapasri Kulalert Department of Clinical Epidemiology, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand; Center of Excellence for Allergy, Asthma and Pulmonary Disease, Thammasat University, Pathum Thani, Thailand https://orcid.org/0000-0003-1438-6437
Patcharaporn Punyashthira Department of Pediatrics, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand; Center of Excellence for Allergy, Asthma and Pulmonary Disease, Thammasat University, Pathum Thani, Thailand https://orcid.org/0000-0002-6799-3954
Orapan Poachanukoon Department of Pediatrics, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand; Center of Excellence for Allergy, Asthma and Pulmonary Disease, Thammasat University, Pathum Thani, Thailand https://orcid.org/0000-0003-0610-8242
Paskorn Sritipsukho Department of Pediatrics, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand; Center of Excellence in Applied Epidemiology, Thammasat University, Pathum Thani, Thailand https://orcid.org/0000-0002-9886-0812
Sira Nanthapisal Department of Pediatrics, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand; Center of Excellence for Allergy, Asthma and Pulmonary Disease, Thammasat University, Pathum Thani, Thailand

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20260003

Keywords:

Nasal irrigation, Mucociliary clearance, Saccharin transit time, Randomized crossover trial, Patient satisfaction

Abstract

Background: Large-volume saline nasal irrigation is widely recommended for sinonasal hygiene, but device design and pressure control influence effectiveness and tolerability. A novel automated irrigation device (NasiCare) utilizes gravity-regulated flow to deliver consistent low-pressure irrigation and may improve user experience compared with manual syringe use. Objectives were to compare the effects of an automated nasal irrigation device versus manual syringe irrigation on mucociliary clearance (MCC), safety, and user satisfaction in healthy adults.

Methods: In this prospective, single-blind, randomized crossover trial, 40 healthy volunteers aged 18-60 years completed two intervention visits: automated NasiCare irrigation and manual syringe irrigation. MCC was assessed using saccharin transit time (STT) pre- and post-irrigation. Adverse effects were recorded using a standardized checklist, and user satisfaction was evaluated across four domains (0-10 visual analog scale).

Results: Baseline pre-irrigation STT did not differ significantly between devices (median 6.58 vs. 6.95 minutes; p=0.380). Both devices resulted in significant post-irrigation STT improvement (p<0.001 for each), with no difference in post-irrigation STT (median 4.76 vs. 4.91 minutes; p=1.000) or STT change (1.59 vs. 1.53 minutes; p=0.085). Adverse events were infrequent and similar between groups, although nasal pain or tightness occurred only with syringe irrigation. Satisfaction scores were significantly higher for NasiCare across all domains, including overall satisfaction (median 10.0 vs. 7.0; p<0.001).

Conclusions: Automated low-pressure nasal irrigation provides MCC benefits comparable to manual syringe irrigation while demonstrating superior user acceptability and similar safety. These findings support the automated device as a reliable and more user-friendly alternative for routine nasal irrigation.

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