In sutra neti, a length of wet string or thin surgical tubing is carefully and gently inserted through the nose and into the mouth. The end is then pulled out of the mouth and while holding both ends at once the string is alternately pulled in and out of the nose and sinuses. It is used to clear the nose and also to remove nasal polyps.
Sutra neti is an advanced form of yogic nasal cleansing and requires an experienced teacher. Sensations of gagging, nausea, and weakness may occur. In case of persistent blockage after jala neti, sutra neti should only be performed after a medical consultation.