Drug Delivery to Paranasal Sinuses Using Pulsating Aerosols

Möller, Winfried; Schuschnig, Uwe; Bartenstein, Peter; Meyer, Gabriele; Häußinger, K.; Schmid, Otmar; Becker, Sven

doi:10.1089/jamp.2013.1071

Cited by 34 publications

(35 citation statements)

References 54 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In order to study the effect of the particle diameter on the deposition efficiency of the particles in the nasal airway, two different particle diameters of 2.4 µm and 10 µm at fixed particle number density are studied. The particle diameter of 2.4 µm is selected since it represents the Sauter mean diameter of the aerosols generated by the PARI SINUS nebulizers [11].…”

Section: Physical Properties and Boundary Conditionsmentioning

confidence: 99%

“…Since CRS occurs in sinuses and connections of the sinuses which are not ventilated properly, the use of a conventional nasal sprays leads to an inefficient delivery of the medication. By using a nasal pump sprays, the particles tend to deposit in the anterior parts of the nasal airway [11] and medication cannot penetrate into the posterior regions of the nasal cavity, the ostia and the sinuses. This is due to the high inertial impaction caused by large particles with diameters of around 60 µm [11].…”

Section: Introductionmentioning

confidence: 99%

“…By using a nasal pump sprays, the particles tend to deposit in the anterior parts of the nasal airway [11] and medication cannot penetrate into the posterior regions of the nasal cavity, the ostia and the sinuses. This is due to the high inertial impaction caused by large particles with diameters of around 60 µm [11]. Recent nebulizers are producing smaller particles in the range of 1-10 µm [11], which could lead to an even distribution of the particles and and improvement of the penetration of the particles to posterior parts of the nasal cavity.…”

Section: Introductionmentioning

confidence: 99%

“…This is due to the high inertial impaction caused by large particles with diameters of around 60 µm [11]. Recent nebulizers are producing smaller particles in the range of 1-10 µm [11], which could lead to an even distribution of the particles and and improvement of the penetration of the particles to posterior parts of the nasal cavity. Accordingly, it is important to study the airflow pattern and the particle dispersion and deposition in different patient-specific nasal cavities.…”

Section: Introductionmentioning

confidence: 99%

“…Accordingly, it is important to study the airflow pattern and the particle dispersion and deposition in different patient-specific nasal cavities. Generating a pulsating airflow may improve the penetration of the airflow into the meatuses which are the connections to the sinuses [11]. Conclusively, the accessibility of the medication into the meatuses and sinuses is improved.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Numerical Simulation of the Dispersion and Deposition of a Spray Carried by a Pulsating Airflow in a Patient-Specific Human Nasal Cavity

Farnoud

Cui

Baumann

et al. 2017

Proceedings ILASS–Europe 2017. 28th Conference on Liquid Atomization and Spray Systems

View full text Add to dashboard Cite

The present numerical study concerns the dispersion and deposition of a nasal spray in a patient-specific human nose. The realistic three-dimensional geometry of the nasal cavity is reconstructed from computer tomography (CT) scans. Identification of the region of interest, removal of artifacts, segmentation, generation of the .STL file and the triangulated surface grid are performed using the software packages ImageJ, meshLab, and NeuRA2. An unstructured computational volume grid with approximately 15 million tetrahedral grid cells is generated using the software Ansys ICEM-CFD 11.0. An unsteady Eulerian-Lagrangian formulation is used to describe the airflow and the spray dispersion and deposition in the realistic human nasal airway using two-way coupling. A new solver called pimpleParcelFoam is developed, which combines the lagrangianParcel libraries with the pimpleFoam solver within the software package OpenFOAM 3.0.0. A large eddy simulation (LES) with the dynamic sub-grid scale (SGS) model is performed to study the spray in both a steady and a pulsating airflow with an inflow rate of 7.5 L/min (or maximum value in case of the pulsating spray) and a frequency of 45 Hz for pulsation as used in commercial inhalation devices. 10,000 mono-disperse particles with the diameters of 2.4 µm and 10 µm are uniformly injected at the nostrils. In order to fulfil the stability conditions for the numerical solution, a constant time-step of 10 −5 s is implemented. The simulations are performed for a real process time of 1 s, since after the first second of the process, all particles have escaped through the pharynx or they are deposited at the surface of the nasal cavity. The numerical computations are performed on the high-performance computer bwForCluster MLS&WISO Production using 256 processors, which take around 32 and 75 hours for steady and pulsating flow simulation, respectively. The study shows that the airflow velocity reaches its maximum values in the nasal valve, in parts of the septum and in the nasopharynx. A complex airflow is observed in the vestibule and in the nasopharynx region, which may directly affect the dispersion and deposition pattern of the spray. The results reveal that the spray tends to deposit in the nasal valve, the septum and in the nasopharynx due to the change in the direction of the airflow in these regions. Moreover, it is found that due to the pulsating airflow, the aerosols are more dispersed and penetrate deeper into the posterior regions and the meatuses where the connections to the sinuses reside.

show abstract

Section: Physical Properties and Boundary Conditionsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Numerical Simulation of the Dispersion and Deposition of a Spray Carried by a Pulsating Airflow in a Patient-Specific Human Nasal Cavity

Farnoud

Cui

Baumann

et al. 2017

Proceedings ILASS–Europe 2017. 28th Conference on Liquid Atomization and Spray Systems

View full text Add to dashboard Cite

show abstract

Comparative study of simulated nebulized and spray particle deposition in chronic rhinosinusitis patients

Farzal

Basu

Burke

et al. 2019

Int Forum Allergy Rhinol

View full text Add to dashboard Cite

Background: Topical intranasal drugs are widely prescribed for chronic rhinosinusitis (CRS), although delivery can vary with device type and droplet size. The study objective was to compare nebulized and sprayed droplet deposition in the paranasal sinuses and ostiomeatal complex (OMC) across multiple droplet sizes in CRS patients using computational fluid dynamics (CFD). Methods:Three-dimensional models of sinonasal cavities were constructed from computed tomography (CT) scans of 3 subjects with CRS refractory to medical therapy using imaging so ware. Assuming steady-state inspiratory airflow at resting rate, CFD was used to simulate 1-µm to 120-µm sprayed droplet deposition in the le and right sinuses and OMC with spray nozzle positioning as in current nasal spray use instructions. Zerovelocity nebulization simulations were performed for 1-µm to 30-µm droplet sizes, maximal sinus and OMC deposition fractions (MSDF) were obtained, and sizes that achieved at least 50% of MSDF were identified. Nebulized MSDF was compared to sprayed droplet deposition. We also validated CFD framework through in vitro experiments.Results: Among nebulized droplet sizes, 11-µm to 14µm droplets achieved at least 50% of MSDF in all 6 sinonasal cavities. Four of 6 sinonasal cavities had greater sinus and OMC deposition with nebulized droplets than with sprayed droplets at optimal sizes. Conclusion:Nebulized droplets may target the sinuses and OMC more effectively than sprayed particles at sizes achieving best deposition. Further studies are needed to confirm our preliminary findings. Several commercial nasal nebulizers have average particle sizes outside the optimal nebulized droplet size range found here, suggesting potential for product enhancement. C 2019 ARS-AAOA, LLC.

show abstract

Sinus irrigation penetration after balloon sinuplasty vs functional endoscopic sinus surgery in a cadaveric model

Gantz

Danielian

et al. 2019

Int Forum Allergy Rhinol

View full text Add to dashboard Cite

BackgroundNasal irrigation is a cornerstone of treatment for chronic rhinosinusitis. The purpose of this study was to quantify irrigation penetration to the sinuses following balloon sinuplasty and functional endoscopic sinus surgery (FESS).MethodsBalloon sinuplasty followed by FESS was performed on 4 cadaver heads. Using a high‐volume, high‐flow bottle, each head was irrigated with fluorescein‐dyed water prior to and following each procedure, and recorded by rigid endoscopy through trephinations. Three blinded, fellowship‐trained rhinologists reviewed videos and scored the extent of staining (using an accepted scale of 0 to 3) for each site.ResultsThe mean score prior to any procedure was maxillary sinus 1.67, frontal sinus 1.29, and nasal cavity 1.71. After balloon sinuplasty the mean was maxillary 2.25, frontal 2.04, and nasal cavity 2.17. After FESS the mean was maxillary 2.75, frontal 2.08, and nasal cavity 2.63. There was a statistically significant increase for both maxillary (p = 0.005) and frontal sinuses (p = 0.006) following balloon sinuplasty. There was a statistically significant increase following FESS compared to balloon for the maxillary sinus (p = 0.003), but not the frontal sinus (p = 0.96). Interrater reliability was good, with Cronbach's alpha of 0.85.ConclusionIrrigation improved in all sinuses following balloon sinuplasty and FESS. There was further improvement to the maxillary sinus after FESS; however, there was no difference in irrigation to the frontal sinuses following FESS compared to balloon sinuplasty. Extended frontal sinus approaches such as the Modified Lothrop procedure should be considered if more extensive access for irrigation is required.

show abstract

Drug Delivery to Paranasal Sinuses Using Pulsating Aerosols

Cited by 34 publications

References 54 publications

Numerical Simulation of the Dispersion and Deposition of a Spray Carried by a Pulsating Airflow in a Patient-Specific Human Nasal Cavity

Numerical Simulation of the Dispersion and Deposition of a Spray Carried by a Pulsating Airflow in a Patient-Specific Human Nasal Cavity

Comparative study of simulated nebulized and spray particle deposition in chronic rhinosinusitis patients

Sinus irrigation penetration after balloon sinuplasty vs functional endoscopic sinus surgery in a cadaveric model

Contact Info

Product

Resources

About