Comparison of Sinus Deposition from an Aqueous Nasal Spray and Pressurised MDI in a Post-Endoscopic Sinus Surgery Nasal Replica

Abstract

Background Optimising intranasal distribution and retention of topical therapy is essential for effectively managing patients with chronic rhinosinusitis, including those that have had functional endoscopic sinus surgery (FESS). This study presents a new technique for quantifying in vitro experiments of fluticasone propionate deposition within the sinuses of a 3D-printed model from a post-FESS patient. Methods Circular filter papers were placed on the sinus surfaces of the model. Deposition of fluticasone on the filter paper was quantified using high-performance liquid chromatography (HPLC) assay-based techniques. The deposition patterns of two nasal drug delivery devices, an aqueous nasal spray (Flixonase) and metered dose inhaler (Flixotide), were compared. The effects of airflow (0 L/min vs. 12 L/min) and administration angle (30° vs. and 45°) were evaluated. Results Inhaled airflow made little difference to sinus deposition for either device. A 45° administration angle improved frontal sinus deposition with the nasal spray and both ethmoidal and sphenoidal deposition with the inhaler. The inhaler provided significantly better deposition within the ethmoid sinuses (8.5x) and within the maxillary sinuses (3.9x) compared with the nasal spray under the same conditions. Conclusion In the post-FESS model analysed, the inhaler produced better sinus deposition overall compared with the nasal spray. The techniques described can be used and adapted for in vitro performance testing of different drug formulations and intranasal devices under different experimental conditions. They can also help validate computational fluid dynamics modelling and in vivo studies.

Gold Nanoparticles: Tunable Characteristics and Potential for Nasal Drug Delivery

“…Using a pMDI device, Siu et al studied sinus targeting in the nasal cavity employing a post-functional endoscopic sinus surgery model. In comparison to a nasal spray, a pMDI produced superior overall sinus deposition (14.5% vs. 2.6%) where low-inertia particles were generated under the optimized conditions (0 L/min flow rate, 45 • administration angle) [51].…”

“…HFA-based pMDIs have been widely utilized for pulmonary drug delivery, but there is little information regarding their performance for nasal drug deposition [51]. The concept of nasal pMDIs was introduced for the treatment of allergic rhinitis to overcome the limitations of aqueous pump sprays, including the loss of formulation by running down the throat or dripping from the nose and the resulting unpleasant taste and burning sensation, which limited the delivered dose and patient compliance.…”

Insulin Delivery to the Brain via the Nasal Route: Unraveling the Potential for Alzheimer's Disease Therapy

“…C A breath-actuated bidirectional delivery device (OptiMist™) [ 96 ]. D A metered dose inhaler with a printed nasal adaptor [ 97 ]. E ViaNase™ [ 98 ].…”