Tap water or “sterile” water for sinus irrigations: what are our patients using?
Bibliographic record
Abstract
BACKGROUND: Nasal saline irrigations are a valuable, widely used adjunct for the management of chronic rhinosinusitis. Due to potential concerns regarding infection, patients are commonly recommended to use distilled, bottled, or boiled tap water when mixing these solutions. Anecdotally, patients frequently inform otolaryngologists that they use tap water for irrigation preparation. The purpose of this study was to assess patient adherence to preparation guidelines. METHODS: This study was a cross-sectional, anonymous survey of 100 consecutive patients using nasal saline irrigations for chronic rhinosinusitis on the instruction of the senior author. Patients received their instructions in a standardized manner including printed handouts and had been instructed to use distilled, bottled, or boiled tap water. RESULTS: Patients almost uniformly reported improvement in their symptoms with the use of saline irrigations. No single water preparation was used by a majority of patients. However, tap water was used by 48% and the most common reason cited for using tap water was convenience. Of the patients using bottled, distilled, or boiled tap water, 65% described the process as "mildly" or "moderately" inconvenient. A large majority (70%) of patients report not adhering to cleaning instructions for their sinus rinse bottles. CONCLUSION: Despite standardized instructions for the preparation of saline irrigation solutions, many patients use untreated tap water. The extremely rare, but typically fatal, risk of meningoencephalitis from Naegleria fowlerii makes this a potential health hazard.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".