A quantitative analysis of the intranasal delivery of topical nasal drugs to the middle meatus: spray versus drop administration

Abstract

The delivery of nasal drugs specifically to the middle meatus is of critical importance in the medical treatment of rhinosinusitis. In this respect, topical nasal drug administration by drops has generally been perceived to be superior to nasal sprays, although there is a lack of evidence to support this notion. This study aims to compare the intranasal delivery of nasal sprays and drops to the middle meatus in vivo, using a novel quantitative method. A surgical patty was placed in the middle meatus. Radio-labelled topical nasal drops and aqueous sprays were administered in a standardized fashion in normal volunteers (10 nasal cavities). The subsequent absorption of administered radio-labelled saline on the patty was measured using a gamma counter. A randomized prospective crossover design was used for the study. The mean percentage (range) of absorbed administered saline on the swab was 8.7 (0.3-39.5) and 9.7 (0.03-20.4) for the spray and drop administration techniques respectively (p = 0.8). Thus, there is wide variation in the delivery of topical nasal drugs and the perceived superiority of nasal drop administration, in terms of delivery to the middle meatus, may be incorrect.

Drug delivery in the nasal cavity after functional endoscopic sinus surgery: a computational fluid dynamics study

“…drug particle size, aerosol pressure and rate, and maxillary ostia size) 4 are still controversial. 5 Various researchers have monitored drug deposition within the nose using in vivo human studies involving computed tomography (CT), 6 gamma scintigraphy with radio-enhanced particles, 7 and endoscopic video imaging using dyed test formulations. 8,9 However, these techniques are invasive and/or difficult to implement in live human subjects, and may involve radiation exposure or deposition of foreign particles within the lung.…”

A Computational Fluid Dynamics Model for Drug Delivery in a Nasal Cavity with Inferior Turbinate Hypertrophy

“…According to the reported studies, the research techniques that can be used for in vivo human studies to monitor drug deposition in the nose are CT imaging, (3) gamma scintigraphy, (4,5) of radio enhanced particles, or endoscopic video imaging of dyed test formulations. (6,7) These techniques are invasive or difficult to implement in human studies, and could cause exposure to radiation or lung deposition of foreign particles.…”

“…However, that is very difficult to avoid for minimized confounding effect and correct deposition of the particles. (4) In the past decades, there have been several developments in the field of computational fluid dynamics (CFD) that enable the researchers to study nasal perforations, (8) turbinate surgery, (9,10) odorant delivery, (11) and many other general studies involving air flow in nasal cavities. (12)(13)(14) Particle drug delivery and deposition were also numerically simulated for a healthy nose cavity, (15)(16)(17) , which presented the effects of particle size, diameter of spray cone, and spray cone angle on the deposition distributions on the cavity wall.…”

Radiographic Distribution of Drops and Sprays within the Sinonasal Cavities

“…Techniques included endoscopic detection of dyed solutions, gamma scintigraphy after application of technetium 99-enhanced solutions, and computed tomography (CT) of contrast-enhanced solutions placed intranasally, as well as development of computational fluid dynamic analysis with MRI. [5][6][7][8][9][10][11][12][13][14][15] One limitation of these methods is the inability to visualize important anatomic landmarks, especially in technetium 99 scintigraphy studies. Endoscopic evaluation may not detect solutions in narrow anatomic spaces.…”