Abstract: Objective To explore the influences of different methods of nasal irrigation on long-term survival， incidence of sinusitis and quality of survival of patients with nasopharyngeal carcinoma （NPC）. Methods According to the random number table， 1134 patients with NPC from July 2008 to December 2012 of our hospital were randomly assigned to receive nasal irrigation by nasal wash machine （group A）， homemade nasal irrigation fittings combined with enemator （group B） or nasal spray （group C） with 378 for each. All patients were followed up for long-term survival and the acute adverse reactions were recorded. The Sino-Nasal Outcome Test 20 was employed to investigate the quality of survival before treatment （T0） and at 6th month （T1）， 1st year （T2）， 2nd year （T3） and 3rd year （T4） after treatment， respectively. Meanwhile， the incidence of sinusitis was recorded. Results All patients were followed up for 3 to 92 months with 5-year overall survival rate and progression-free survival rate of 80.5％ and 73.2％. No significant differences were observed among three groups on overall survival， progression-free survival and incidences of salivary gland and neck skin damage. The incidence of grade 3／4 oropharyngeal mucosa damage of group C was higher than those of other two groups with significant difference （P＜0.05）. The incidences of sinusitis at T0， T1， T2， T3 and T4 were 41.7％， 56.3％， 74.0％， 54.1％ and 69.6％. The incidences of sinusitis at T2， T3 and T4of Group A were lower than other two groups （P＜0.05）. There were a lower incidence at T2 and a higher incidence at T4 in Group B versus Group C （P＜0.05）. The sinusitis symptom scores at T1 and T2 were lower than those at T0 in all three groups （P＜0.05）， while only the Group C’s sinusitis symptom scores were lower at T3 and T4 than T0 （P＜0.05）. The Group C’s sinusitis symptom scores were lower than other two groups at T2 and T4 （P＜0.05）.Conclusion Different methods of nasal irrigation had no influence on the long-term survival of patients with NPC. Nasal spray can increase the risk of oropharyngeal mucosa damage with a worst quality of survival during the follow-up.