... The Neti Pot isasoothingnasallavage.Asaltmixtureofappropriateconcentration and temperatureisprepared. The patientleansover the sink and applies the Neti Pot to the uppernostril, the salinesolutionflowsthrough the nasal and sinuscavities and around the backwallof the septum and washes the oppositenasal and sinuscavitiesbeforeexiting the dependentnostril. ... towashout the secretionsiftheycannotbeeffectivelyremovedwithsalinesprayalone.Inpatientswhohavealreadyhadsinussurgerythisisslightlymorecontroversial,sincesomephysiciansbelievethat10FIGURE2– The maxillary,frontal, and ethmoidsinusesdraininto the middle meatus,whichisborderedby the middle turbinatebone. The osteomeatalcomplex(OMC)is the GrandCentralStationof the sinuses.Anyprocessthatcausesswelling and blockageofthiscriticalareacontributesto the symptomsofsinusitis.While the wateryseroussecretionsplayaroleinhumidification and warming, the secretionsof the gobletcells and mucousglandsfacilitate the removalofparticulatematter.Thismucous ... 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 smallopeningsfromswelling(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...