SinuPulse Elite® Advanced Sinus Irrigation System
Pulsatile SinuNasal Irrigation, Treatment Options, and Reimbursement

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The SinuPulse Elite® Advanced Sinus Irrigation System is a revolutionary treatment for sinus sufferers, which utilizes pulsatile irrigation designed for cleansing and treatment of the nasal cavity, nasopharynx, and paranasal sinuses to stimulate the nasal cilia, remove bacterial and fungal toxins. Designed for use with saline solutions, antibiotics, and anti-fungal agents delivering treatment at the source of the problem. The SinuPulse Elite® increases the effectiveness of sinusitis-fighting antibiotics and targets the area of infection. Unlike other sinusitis treatments, the device provides an easy to use non invasive alternative with patients reporting faster and longer-lasting relief with fewer problems or side effects.

 

Insurance Payment for SinuPulse Elite® Advanced Sinus Irrigation System

 

• Physician office irrigation and insurance payments bill RVS 31000-52. Pulsatile irrigation is generally reimbursed at the rate of $45.00 subject to combination of RVS (procedure) and CPT (diagnosis) coding. If used with antibiotic or antifungal agents, add for medications.

 

• Patient Insurance reimbursement for SinuPulse Elite® unit bill HCPCS-E1399

 

SinuPulse Elite® Advanced Sinus Irrigation System

 

Technique:
1. Add one tsp of SinuAir™ powdered saline or non iodized salt to 500 cc of water
2. Adjust flow to about one inch high stream out of bulb tip
3. Irrigate 250 cc on left side
4. Irrigate 250 cc on right side.
5. Clear Nose GENTLY !
6. Sit quietly for 10 minutes. Don’t blow the nose

 

Principle:
Irrigation removes bacterial and fungal toxins, as well as thick mucus that holds these products. Biofilm and the bacteria they protect are also removed by pulsation. The pulsation action is needed because the bacterial and fungal toxins inhibit cilia movement and hence reduce natural defense.

Recommended Protocol:

After 300 cc of irrigation, if there still remains purulent material in the nose, continue irrigation till clear. If a mild or chronic infection, do once a day for 20 days then re evaluate. If a heavy purulent infection, do BID for 20 days.

 

Applications

 

Allergy And Pollen
Inhibition Of The Seasonal Ige Encrease To Dactylis Glomerata By Daily Saline Nasal-
Sinus Irrigation During The Grass Pollen Season,

J. Subiza, M.D. Journal of Allergy and Clinical Immunology. September 1999.
Pulsatile irrigation works for allergy by removing the IgE so that the pollen doesn't cause symptoms.

 

Medical Management of Rhinitis, Fadal R. English: Otolaryngology Vol 2:Ch 13
The principal benefits from saline irrigation include: Augments mucociliary flow, liquefies tenacious mucus, soothes irritated tissues, removes crusts and microforeign bodies, augments tissue repair, reduces forceful nose blowing, improves olfaction.

 

Rhinitis, Allergy: Principles and Practice, 3rd edition. Middleton E. CV Mosby Company Ch 17, 1988
All forms of allergy rhinitis are benefited by pulsatile saline irrigation.

 

Asthma
Sinusitis and Bronchial Asthma, Slavin RG: J Allergy and Clinical Immunol 66:250-257, 1980
Slavin presents three mechanisms re sinusitis causing asthma. Clearing sinusitis is important in asthma.

 

Post Operative Care
Evaluation of methods of Sinus Nasal Irrigation Post Sinus Surgery, Cenjor, C. Gutierrez, R. Congress of Spanish Society of Otolaryngology and Cervical Facial Pathology.
Las Palmas de Gran canaria, 16 Octubre de 1998
“Pulsatile Irrigation {Grossan} is the preferred method of treatment after endoscopic surgery. Highly accepted by patients.

 

Fungus Infection
Effect of anti-fungal nasal lavage with amphotericin B on nasal polyposis
Ricchetti A, Landis BN, Maffioli A, Giger R, Zeng C, Lacroix JS., J Laryngol Otol 2002 Apr;116(4):261-3
Rhinology Unit, Department of Otorhinolaryngology - Head and Neck Surgery, Geneva Univ. Hospital, Switzerland.

 

Cystic Fibrosis
Management Of Sinusitis In Cystic Fibrosis,
Moss , King W. Arch Otolaryngol Head Neck Surg. 1995;1 21:566-572.
Stresses the use of “pulsatile irrigation” for home use. Recommends antibiotic irrigation of sinuses.

 

References
Management Of Sinusitis In Cystic Fibrosis,
Moss , King W. Arch Otolaryngol Head Neck Surg.1995;121:566-572.
Stresses the use of “pulsatile irrigation” for home use. Recommends antibiotic irrigation of sinuses.

 

Method For Rapid Evaluation Of Topically Applied Agents To Cystic Fibrosis, Wine JJ, King W, Lewiston NJ Am J Physiol. 1991261 (Lung Cell Mol Physiol. 5):L21 8-L221
Pulsatile sinus irrigation makes an ideal vehicle for local administration of antibiotics and other products.

Management of Chronic Sinusitis in Cystic Fibrosis, Davidson, T., Laryngoscope 105:354 April 1995.


Cystic fibrosis is commonly associated with sinusitis due to mucociliary system failure. Patients may benefit by lung transplant. Pre-op pulsatile saline irrigation with tobramycin is found to be a successful means of clearing the sinus of disease.

 

Using Pulsatile Pressure Saline/Antibiotic Irrigation,
Betts N. Compendium Contin Educa Dent, 17(9): 871 1996.
The efficacy of pulsatile saline irrigation in removing bacteria is demonstrated in orthopedics, surgery and dental literature too.

 

Effect of anti-fungal nasal lavage with amphotericin B on nasal polyposis, Ricchetti A, Landis BN, Maffioli A, Giger R, Zeng C, Lacroix JS. J Laryngol Otol 2002 Apr;116(4):261-3
Rhinology Unit, Department of Otorhinolaryngology - Head and Neck Surgery, Geneva Univ. Hospital, Switzerland

 

Recent studies have suggested that allergic fungal rhino-sinusitis could be involved in the development of nasal polyposis. The aim of this study was to evaluate the response of anti-fungal nasal lavages. Patients performed nasal lavage with 20 ml of a one per one thousand amphotericin B suspension in each nostril, twice a day, for four weeks. In addition, all patients continued their saline nasal lavage and their conventional topical corticosteroid spray. This study included 74 patients, with a mean age of 46 years (range from 19 to 73). Before anti-fungal treatment, the distribution of nasal polyposis, according to Malm, was: 13 patients in stage I (17.5 per cent), 48 patients in stage II (65 per cent) and 13 patients in stage III (17.5 per cent). After anti-fungal nasal lavages, the total disappearance of nasal polyposis was observed in 29 patients (39 per cent). Eight patients were stage I, 21 stage II, and none stage III. In patients who have had previous endoscopic polypectomy and functional endoscopic sinus surgery, total disappearance of nasal polyposis was seen in 24 patients (47 per cent). Hyper-reactivity to fungal organisms could be one of the mechanisms underlying the development of nasal polyposis. A direct effect of amphotericin B suspension on the integrity of the cell membrane of the polyp epithelium could not be excluded.