Intranasal drug delivery devices and interventions associated with post-operative endoscopic sinus surgery

Abstract

This review article highlights the importance and advantages of the drug delivery systems applied via the nasal route after endoscopic sinus surgery (ESS) for patients suffering from chronic rhinosinusitis (CRS). After ESS, patients often require ongoing topical and systemic medication. To reduce the incidence of immediate and delayed post-surgical complications, a variety of temporary post-operative nasal interventions are currently used. However, newly developed intranasal drug delivery devices can enhance tissue recovery after ESS by releasing therapeutic drugs locally, while providing structural support to reduce tissue adhesion and scaring. Intranasal drug delivery devices are promising next generation post-surgery devices, offering advantages for enhancing tissue recovery through release of loaded therapeutic drugs locally in a controlled manner over the required time-frame during post-operative healing. The mechanisms and effectiveness of these drug delivery systems initiate a new era in providing topical controlled drug delivery to the sinus tissue and can be a guide for the future development of specific effective therapies of preparations with other drugs that otherwise should be administered parenterally. Hence, further research is required to validate their efficacy.

A thermoresponsive hydrogel system for long-acting corticosteroid delivery into the paranasal sinuses

“…Furthermore, currently available degradable sinus stents have a total loaded dose of 370 μg or 1350 μg mometasone per device and are designed for gradual release over 30 or 90 days, respectively [27,28]. In patients with severe inflammation, increased steroid dosing with sustained delivery may be warranted and provide more effective symptom relief [29]. The PLGA MS component of TEMPS enables sufficient surface area-to-volume loading of mometasone, as well as flexible dosing by adjusting the amount of MSs in the system [30].…”

Postoperative placement of an anti‐fibrotic poly L‐lactide electrospun fibrous membrane after sinus surgery

“…6 In efforts to reduce local tissue fibrosis and adhesion, pharmaceutical treatments (tablets, drops, sprays, and powders) are often prescribed. 23 However, compliance and absorption are poor, side effects may develop, and patients are inconvenienced. Nasal packings lack these disadvantages, but are uncomfortable, blocking the nasal cavity, and may trigger foreign body reactions.…”

“…In efforts to reduce local tissue fibrosis and adhesion, pharmaceutical treatments (tablets, drops, sprays, and powders) are often prescribed 23 . However, compliance and absorption are poor, side effects may develop, and patients are inconvenienced.…”

Recent Advances in Intranasal Administration for Brain-Targeting Delivery: A Comprehensive Review of Lipid-Based Nanoparticles and Stimuli-Responsive Gel Formulations

“… 14 The outermost nasal cavity is the vestibule (0.6 cm 2 ), which is lined by keratinized and stratified squamous epithelium with embedded vibrissa. 22 , 23 The vestibule filters foreign substances larger than 10 µm via the mucus layer covering the surface of the vibrissa. The vestibule exhibits low drug permeability because of the keratinized squamous epithelium.…”