Factors Affecting Sinus Irrigation Non-compliance: Research into Nasal Solution

Monday, October 19, 2026

1:18 PM - 1:24 PM PT

Location: Theatre 411

Presenting Author(s)

BP

Ben M. Palatnik, B.S.

Mr.
University of Minnesota- Twin Cities
St. Paul, MN, United States

Co-Author(s)

DC

David J. Cvancara, MD

Dr.
University of Minnesota- Department of Otolaryngology
Minneapolis, MN, United States
CK

Cynthia Koenigsberg, MD

Resident Physician
University of Minnesota- Department of Otolaryngology, United States
Alec Straughan, MD

Dr.
University of Minnesota- Department of Otolaryngology
Minneapolis, Minnesota, United States
NG

Neal Godse, MD

Associate Professor
University of Minnesota Department of Otolaryngology
Minneapolis, Minnesota, United States

Senior Author(s)

KR

Kolin Rubel, MD

MD
Department of Otolaryngology, University of Minnesota, MN, USA, United States

Disclosure(s):

Ben M. Palatnik, B.S.:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Nasal irrigation (NI) is the gold-standard treatment for inflammatory sinonasal disease, but compliance can be challenging for reasons that remain poorly studied. In this study, we utilize a novel combination of modified objective and subjective measures to characterize factors affecting NI compliance.

Methods: This cohort study enrolled patients with inflammatory sinonasal disease from a tertiary rhinology clinic in late 2025. Disease severity was evaluated with SNOT-22 and compliance with sinus irrigation was evaluated using a modified Barriers to Care Questionnaire (BQC) and a modified medication adherence rating scale (MARS) with questions specific to NI. Data was collected and stored in REDCap. Descriptive statistics were performed using Graphpad Prism. This study was approved by the University of Minnesota Institutional Review Board (STUDY00023779).

Results: 37 patients (SNOT-22 – mean 32.2±15.0; 57% male; age 49.1±18.5) were included. NI took an average of 7.2±4.6 minutes, including preparation and administration. Within the BQC ‘skills’ and ‘pragmatism’ subdomains, 50% reported only using NI with active symptoms, 38% ease of use, 30% inconvenience, 27% reported poor sleep, and 24% difficulty remembering as contributors to NI noncompliance. ‘Expectation’ factors such as lack of immediate improvement and absence of disease exacerbation without NI generally also reduced compliance (35% and 30%, respectively). MARS scores were generally intermediate (25.2/50 ± 9.1). Within individual categories, only using NI when needed or feeling poorly scored worst (3.6/5 ± 1.4, 3.1/5 ±1.4, respectively). This further suggests that patient understanding of disease chronicity may negatively influence treatment compliance.

Conclusions: Our study is one of the first to evaluate modifiable barriers to NI compliance. This work found that patient habit formation, education, and expectations could contribute to compliance. A better understanding of modifiable barriers to NI compliance could lead to improved patient outcomes and quality of life.