Current Perspective on Nasal Delivery Systems for Chronic Rhinosinusitis

Abstract

Chronic rhinosinusitis is an upper respiratory disease during which topical drug treatment via the nasal cavity is the most actively utilized therapeutic strategy. In addition to steroids, antibiotics, and antifungal agents, which are widely used in clinical practice, research on novel topical agents to improve the bacterial biofilm or mucociliary clearance remains ongoing. Moreover, owing to the complex structure of the nasal cavity, the effects of nasal drug delivery vary depending on factors related to delivery fluid dynamics, including device, volume, and compounds. In this article, we review methods and compounds that have been applied to chronic rhinosinusitis management and introduce recent advances and future perspectives in nasal drug delivery for upper respiratory diseases.

Sinonasal Stent Coated with Sustained-Release Varnish of Mometasone Furoate Inhibits Pro-Inflammatory Cytokine Release from Macrophages: An In Vitro Study

“…Nasal drops, nasal sprays, and nasal irrigation have the advantages of being simple and economical but have present disadvantages, such as patient compliance, inaccurate dosage, and difficulty in reaching the depth of the nasal cavity. Biomaterials and sinus implants have provided more durable and effective nasal drug delivery post-surgery [ 48 ]. The use of such slow-release devices proposed herein has the advantage that the drug is delivered locally, with sustained, low concentrations, thereby extending the time of action and reducing the toxicity of single high dosages.…”

Pharmacological, Technological, and Digital Innovative Aspects in Rhinology

“…Over the years, the biomaterials have been used in the CRS post-operative management settings. Polylactide sinus implants, polyurethane foam, and carboxymethylcellulose were commonly used biomaterials ( 47 ). The bio-absorbable implants represent an example of innovative pharmaceutical technologies.…”

“…They allow sustained-release corticosteroids to be delivered locally directly to inflamed sinus tissues. Once implanted, these expand to fit different sizes and shapes, adapting to the space after surgery ( 47 ).…”

Maximizing Postoperative Recovery: The Role of Functional Biomaterials as Nasal Packs—A Comprehensive Systematic Review without Meta-Analysis (SWiM)

“…Several ingenious strategies have been implemented in an effort to surmount these limitations, including nanomaterial-based systems that provide targeted and sustained drug delivery, as well as enhanced wound healing [ 14 , 15 ]. These systems can be developed to have certain characteristics, such as controlled release kinetics and antimicrobial capabilities, and can be adapted to the need of each patient [ 16 ]. However, additional study is required to establish their safety and effectiveness before these technologies can be extensively employed in clinical practice, because they are still in the early phases of development.…”