Retrospectacle: A Neuroscience Blog

I got an email from the head of this study, David F. Colvard, MD, of Raleigh, North Carolina. His team has shown that nasal irrigation can help solve a common problem for scuba divers: middle ear squeeze. This refers to the phenomenon divers experience during ascent and descent in the sea, when external pressure differences cause compression in the middle ear. This can cause damage and hearing impairment, if serious. To combat this, usually divers take a decongestant in either pill or spray form. However, Dr. Colvard’s study has shown that nasal irrigation helped divers achieve middle ear equalization and reduced their reliance on decongestants.

Between November 2005 and September 2006 one hundred (100) scuba divers completed web-based “Before” and “After” questionnaires. They were invited to participate based on a diver safety survey conducted in 2004 by Dr. Colvard. Only those divers who reported difficulty equalizing the pressure in their middle ears or were using decongestants were invited to participate in the study. After completing the “Before” questionnaire, the study participants were sent free samples of NeilMed’s SINUS RINSE™ buffered saline nasal irrigation system. They completed the “After” questionnaire after using the product and completing the diving.

Study highlights include the following:

Forty-four (44.0%) reported less nasal congestion after using SINUS RINSE™ system.
Sixty-nine (69.0%) reported reduced difficulty in clearing or equalizing their ears.
Forty-one of 68 divers (60.3%) who used oral decongestants reported decreased use, or discontinued use completely.
Twenty-one of 38 divers (55.3%) who used decongestant sprays or nasal drops reported decreased use, or discontinued use completely.
None reported increased use of decongestants in any form.
Seventy-two (72.0%) were satisfied with their experience and indicated that they would recommend the SINUS RINSE™ system to other divers.

This NeilMed stuff *IS* pretty good. I wanted to report this study because I also participated in a NeilMed study (not this one), and I had to admit that I felt a huge improvement in my allergies after using it for 6 weeks everyday. Its pretty simple, sterile saline packet and warm water in a nozzled-bottle. And its not as uncomfortable as you’d think. Check out or for more info.


  1. #1 ERV
    April 16, 2007

    … Would this stuff work on airplane ear-popping too? I dread flying because theres always an 85-90% chance that Ill be buckled over in pain during the descent because of weird ear popping.

  2. #2 Shelley
    April 17, 2007

    Very likely it would, as middle ear equalization (or lack thereof) is what causes that pain. Reducing the mucous and clensing the sinuses would clear the eustatian tubes, which is how the middle ear gets equalized. The tube connects the throat with the middle ear, and when blocked, the middle ear cannot equalize (thats why burping, swallowing, coughing, sneezing, etc can clear your ears in-flight).

  3. #3 Lab Lemming
    April 18, 2007

    I might have asked this before, but Shelley, how do you know you weren’t on a placebo irrigation?

  4. #4 Shelley
    April 18, 2007

    They gave it to me in the sealed NeilMed box, and it was salty. They told me what group I was assigned to (when I was randomly assigned) because of the differences in how the apparatus looked. It would have been obvious which group you were in.

    There were two other groups: saline spray bottle (small amt pre-mixed non-irrigation) and nothing.

  5. #5 Mark Boolootian
    April 26, 2007

    Murray Grossan, an ENT at Cedars Sinai, has done a great deal of work on the benefits of nasal irrigation. He works with divers a great deal and has some info for diving-related issues on this page:

    Irrigation can be performed using a plain saline solution or, preferrably, something akin to Ringers solution. The important part of the process isn’t the composition of the solution, it’s the irrigation.

  6. #6 David F Colvard MD
    October 2, 2007

    I presented the sinus rinse diver study data at the SAUHMA dive medicine refresher course in Johannesburg South Africa last week and it was well received. Also, to dive professionals the day before in a diver stress workshop. It is possible that the SPUMS journal will publish the study next year. The results have already been in Scuba Diving magazine.

    There were also two UAE flight attendants at the same hotel over-nighting and they were very excited about using it while flying, so i gave them some samples to use. They told me that many flight crews use sudafed every day they fly. I have not done a study with flight crews.

    I use Sinus Rinse myself before flying and find it helps me. During my most recent dive trip to Bonaire I did not use any decongestants, which was a tremendous improvement over daily 12-hour Sudafed.

    Yes, I am now a paid consultant to Neilmed Pharmaceuticals, but my wife says they don’t pay me nearly enough. My private practise pays the bills.

    I would very much appreciate feedback on Sinus Rinse use in diving and flying.

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