Nasal Gel and Olfactory Cleft

González‐Botas, Jesús Herranz; Seara, Anselmo Padín

doi:10.1016/j.otoeng.2012.09.005

Cited by 5 publications

(5 citation statements)

References 19 publications

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“…This study is thus the first in the literature to show the ability of irrigations to thoroughly deposit topical agents to the olfactory mucosa. In contrast, as demonstrated in prior studies [12][13][14] and confirmed in this investigation, sprays are minimally successful in delivering topical solutions to the olfactory subsites. Irrigations and sprays, however, are comparably effective in delivering agents to the anterior and middle nasal cavity.…”

Section: Discussioncontrasting

confidence: 45%

Comparison of nasal sprays and irrigations in the delivery of topical agents to the olfactory mucosa

et al. 2013

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Section: Discussioncontrasting

confidence: 45%

Comparison of nasal sprays and irrigations in the delivery of topical agents to the olfactory mucosa

et al. 2013

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“…Patients with PIOD have an odds ratio of 2.77 of achieving a minimum clinically important difference (MCID) on olfactory testing versus control 1757 . A shorter duration of olfactory loss has also been associated with greater recovery with OT in several studies 1758–1760 . Haehner et al 1761 found, in a prospective cohort study with COT for 12 weeks, in patients with PD an improvement on TDI and on threshold for the four scents used for training.…”

Section: Managementmentioning

confidence: 99%

“…1757 A shorter duration of olfactory loss has also been associated with greater recovery with OT in several studies. [1758][1759][1760] Haehner et al 1761 found, in a prospective cohort study with COT for 12 weeks, in patients with PD an improvement on TDI and on threshold for the four scents used for training. Last, Lamira et al 1762 found that OT in adults with age-related olfactory loss (mean age, 66 years) showed a clinically significant improvement in olfaction in 44% of patients who completed the study, but the investigation had a dropout rate of 45%.…”

mentioning

confidence: 99%

“…1524 Other head positions (head-tilted forward, vertex-to-floor, neutral position, head reclined, and lateral head low) have demonstrated variable success in topical delivery. [1523][1524][1525][1526][1527][1528][1529][1530][1531] Middle turbinate resection failed to improve delivery of irrigation to the olfactory mucosa. 1532 Thus, the volume of rinses appears to be important in accessing the olfactory mucosa and may explain why nasal steroid rinses but not sprays are beneficial in treatment of nonsinonasal disease OD.…”

mentioning

confidence: 99%

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International consensus statement on allergy and rhinology: Olfaction

Patel

Holbrook

Turner

et al. 2022

Int Forum Allergy Rhinol

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Background:The literature regarding clinical olfaction, olfactory loss, and olfactory dysfunction has expanded rapidly over the past two decades, with an exponential rise in the past year. There is substantial variability in the quality of this literature and a need to consolidate and critically review the evidence. It is with that aim that we have gathered experts from around the world to produce this International Consensus on Allergy and Rhinology: Olfaction (ICAR:O). Methods: Using previously described methodology, specific topics were developed relating to olfaction. Each topic was assigned a literature review, evidence-based review, or evidence-based review with recommendations format as dictated by available evidence and scope within the ICAR:O document. Following iterative reviews of each topic, the ICAR:O document was integrated and reviewed by all authors for final consensus. Results:The ICAR:O document reviews nearly 100 separate topics within the realm of olfaction, including diagnosis, epidemiology, disease burden, diagnosis, testing, etiology, treatment, and associated pathologies. Conclusion:This critical review of the existing clinical olfaction literature provides much needed insight and clarity into the evaluation, diagnosis, and treatment of patients with olfactory dysfunction, while also clearly delineating gaps in our knowledge and evidence base that we should investigate further.

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“…Prior research has shown that the olfactory region receives less than 1% of aerosol medications that are administered intranasally [ 13 ]. González-Botas et al found that when utilizing a typical radial-hole inhaler that dispenses 140 mL per application, most of the medication was deposited within the nasal valve and inferior meatus, with very little deposited in the olfactory cleft [ 14 ]. Accordingly, the significantly low amount of medication that can reach the brain through the nose has hindered the clinical use of N2B drug delivery and has become a significant obstacle in the advancement of neurological therapies via the nasal route [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Visualization and Estimation of Nasal Spray Delivery to Olfactory Mucosa in an Image-Based Transparent Nasal Model

Seifelnasr

April

2023

Pharmaceutics

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Background: Nose-to-brain (N2B) drug delivery offers unique advantages over intravenous methods; however, the delivery efficiency to the olfactory region using conventional nasal devices and protocols is low. This study proposes a new strategy to effectively deliver high doses to the olfactory region while minimizing dose variability and drug losses in other regions of the nasal cavity. Materials and Methods: The effects of delivery variables on the dosimetry of nasal sprays were systematically evaluated in a 3D-printed anatomical model that was generated from a magnetic resonance image of the nasal airway. The nasal model comprised four parts for regional dose quantification. A transparent nasal cast and fluorescent imaging were used for visualization, enabling detailed examination of the transient liquid film translocation, real-time feedback on input effect, and prompt adjustment to delivery variables, which included the head position, nozzle angle, applied dose, inhalation flow, and solution viscosity. Results: The results showed that the conventional vertex-to-floor head position was not optimal for olfactory delivery. Instead, a head position tilting 45–60° backward from the supine position gave a higher olfactory deposition and lower variability. A two-dose application (250 mg) was necessary to mobilize the liquid film that often accumulated in the front nose following the first dose administration. The presence of an inhalation flow reduced the olfactory deposition and redistributed the sprays to the middle meatus. The recommended olfactory delivery variables include a head position ranging 45–60°, a nozzle angle ranging 5–10°, two doses, and no inhalation flow. With these variables, an olfactory deposition fraction of 22.7 ± 3.7% was achieved in this study, with insignificant discrepancies in olfactory delivery between the right and left nasal passages. Conclusions: It is feasible to deliver clinically significant doses of nasal sprays to the olfactory region by leveraging an optimized combination of delivery variables.

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Nasal Gel and Olfactory Cleft

Cited by 5 publications

References 19 publications

Comparison of nasal sprays and irrigations in the delivery of topical agents to the olfactory mucosa

Comparison of nasal sprays and irrigations in the delivery of topical agents to the olfactory mucosa

International consensus statement on allergy and rhinology: Olfaction

Visualization and Estimation of Nasal Spray Delivery to Olfactory Mucosa in an Image-Based Transparent Nasal Model

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