... The NetiPotisasoothingnasallavage.Asaltmixtureofappropriateconcentration and temperatureisprepared. The patientleansover the sink and applies the NetiPotto the uppernostril, the salinesolutionflowsthrough the nasal and sinuscavities and around the backwallof the septum and washes the oppositenasal and sinuscavitiesbeforeexiting the dependentnostril. ... iumchloride,areoccasionallyused. The airwaysarelinedbyalayerofprotectivemucusgelthatsitsatopawaterypericiliaryfluid.Mucusisanadhesive,viscoelasticgel, the biophysicalpropertiesofwhicharelargelydeterminedbyentanglementsoflongpolymericgel‐formingmucins,MUC5AC and MUC5B.Thislayerentraps and clearsbacteria and inhibitsbacterialgrowth and biofilmformation.Italsoprotects the airwayfrominhaledirritants and fromfluidloss.(38)Althoughguafenisiniscommonlyprescribedin the treatmentofsinusitis,medicalevidenceofefficacyisscarce.(39)Mucoactivemedicationsincludeexpectorants,mucolytics, and mucokineticdrugs.Expectorantsaremeanttoincrease the volumeofairwaywaterorsecretioninordertoincrease the effectivenessofcough.Althoughexpectorants,suchasguaifenesin(eg,RobitussinorMucinex),aresoldover the counter,thereisnoevidencethattheyareeffective for the therapyofanyformoflungdisease, and whenadministeredincombinationwithacoughsuppressantsuchasdextromethorphan (the "DM"insomemedicationnames)thereisapotentialriskofincreasedairwayobstruction.(38)114H.CromolynSodium ... terlevelrises and areservoirforms.Similarly,if the osteomeatalcomplexisblocked,abackupofmucusoccurs.Thiscanleadtoaconditionthatleadstoinfection.Bacterialivein the nose and sinuses;however,inaninfectiousstatesomesubset(s)ofbacteriahavereproducedoutofproportiontoothers.Thisbacterialovergrowthisoftenpresentinsinusitis–particularlyacutesinusitis.Anyprocessthatcausesmucosalinflammationinto the sensitiveareaof the osteomeatalcomplex(OMC)canocclude the othersinusesthatdrainintothiscrossroadzone.(16‐20)Blockageof the small openingsfromswelling(causedbyinfection,allergy, and othercauses)canalsoresultinsinusitis.Whenobstructionoccurs, the mucusisretainedin the sinuscavity.Thesestagnantsecretionsthicken and provideamedium for bacterialgrowth.Obstructionalsoimpairsaeration and gasexchangewithin the sinuscavity.Absorptionoftrappedoxygenleadstohypoxiaordecreasedoxygenlevelswithin the sinus,whichexacerbatessinusitis.Thesechangesleadtodamage and dysfunctionof the cilia and epithelium. The retainedsecretions and infectionleadtofurthertissueinflammation,whichinturnleadstofurtherblockage.Thesechanges120help the bodyfightsinusitis.(51‐52).However,onecriticismofthisuseof the macrolideantibioticsisthatthereisariskthatbacteriacouldbecomeresistanttotheseantibioticsiftheyareoverused,therebypotentiallycreatingadifficultproblemintreatinginfectionwithresistantbacteria.N.Steroids...