Nasal saline irrigation – A review of current anatomical, clinical and computational modelling approaches

Salati, Hana; Bartley, Jim; White, David E.

doi:10.1016/j.resp.2019.103320

Cited by 12 publications

(8 citation statements)

References 43 publications

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“…To date, this common defect for studies on intranasal drug deposition using sinonasal models, cadaverous heads, or computer simulation has not been satisfactorily solved, even though the environmental conditions were set to simulate the body temperature and humidity. 10,25 However, we found that the droplets deposited on the replica surface did not move when we observed the distribution under the endoscope and also when we disassembled the model gently, which suggested that post-deposition dripping was negligible under the conditions of our experiments (ie, observation time, deposition amount, and thermoplastic polyurethane elastomer surface). Therefore, although the physiological characteristics of the mucosa and mucociliary transport could not be mimicked using 3D printed models, the initial range of the aerosol deposition reflected by the staining still offered valuable information for decision-making in clinical work and device innovation.…”

Section: Discussionmentioning

confidence: 74%

“…The model surface was not yet able to simulate the viscosity, humidity, and ciliary movement of the nasal mucosa in vivo . To date, this common defect for studies on intranasal drug deposition using sinonasal models, cadaverous heads, or computer simulation has not been satisfactorily solved, even though the environmental conditions were set to simulate the body temperature and humidity 10,25 . However, we found that the droplets deposited on the replica surface did not move when we observed the distribution under the endoscope and also when we disassembled the model gently, which suggested that post‐deposition dripping was negligible under the conditions of our experiments (ie, observation time, deposition amount, and thermoplastic polyurethane elastomer surface).…”

Section: Discussionmentioning

confidence: 85%

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Assessment of three types of intranasal nebulization devices in three‐dimensional printed models and volunteers: a pilot study

Dong

Cai

Huang

et al. 2020

Int Forum Allergy Rhinol

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Background Intranasal nebulization is an effective treatment for chronic rhinosinusitis and allergic rhinitis however terminal inhalation devices have not been fully studied We compared the sinonasal aerosol distributions and adverse effects of different inhalation units Methods A mask double-head nozzle and single-head nozzle were applied to atomize the methylene blue solution to-dimensional printed models of the pediatric nasal cavity adult nasal cavity with septal deviation and postsurgical paranasal sinuses and staining of the different sites was scored Volunteers received nebulization of normal saline via different devices therea er the adverse effects were assessed using the visual analogue scale VAS Results A er nebulization the staining scores for the middle turbinate and middle meatus of the pediatric and adult nasal cavity models and the score for the anterior ethmoid sinus of the sinus model with the single-head nozzle were significantly higher than those with the mask and double-head nozzle all p < η for effect size estimates were above Among the volunteers the adverse effects including nasal irritation facial pressure/pain ear full-ness/pain postnasal drip and throat irritation/cough were mild The variations in the incidence and VAS scores of the adverse effects among the devices were not significant all p > Conclusion The single-head nozzle was the most effective device in aerosol delivery to the lateral wall of the nasal cavity and sinuses conversely the mask yielded limited sinonasal deposition Intranasal nebulization was well tolerated and the adverse effects among the devices were comparable These findings are meaningful for selecting and developing inhalation units © 2020 ARS-AAOA, LLC.

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Section: Discussionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 85%

Assessment of three types of intranasal nebulization devices in three‐dimensional printed models and volunteers: a pilot study

Dong

Cai

Huang

et al. 2020

Int Forum Allergy Rhinol

View full text Add to dashboard Cite

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“…So, surface coverage and wall shear stress are essential factors in investigating saline irrigation for postoperative patients. These studies have used CFD to investigate saline distribution pre and post-surgery [4,12,19,20,[22][23][24][25][26]. To our knowledge, this CFD study is the first one which used a saline irrigation profile obtained from physical experiments to examine nasal saline irrigation on three post-FESS patients.…”

Section: Discussionmentioning

confidence: 99%

Nasal irrigation delivery in three post-FESS models from a squeeze-bottle using CFD

Singh¹,

Khamooshi²,

Vahaji³

et al. 2022

Preprint

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Purpose: Nasal saline irrigation is highly recommended in patients following functional endoscopic sinus surgery (FESS) to aid the postoperative recovery. Post-FESS patients have significantly altered anatomy leading to markedly different flow dynamics from those found in pre-op or non-diseased airways, resulting in unknown flow dynamics.Methods: This work investigated how the liquid stream disperses through altered nasal cavities following surgery using Computational Fluid Dynamics (CFD). A realistic squeeze profile was determined from physical experiments with a 27-year-old male using a squeeze bottle with load sensors. The administration technique involved a head tilt of

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“…Impaired mucociliary clearance occurs during the postoperative period, which results in the accumulation of secreted mucus in the sinonasal cavity [ 2 ]. Irrigating the sinonasal mucosa with liquid saline assists the mucociliary clearance functions hence improving postoperative care [ 3 , 4 ]. Irrigation results in direct mechanical removal of mucous and inflammatory products [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Nasal Irrigation Delivery in Three Post-FESS Models From a Squeeze-bottle Using CFD

et al. 2022

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Purpose Nasal saline irrigation is highly recommended in patients following functional endoscopic sinus surgery (FESS) to aid the postoperative recovery. Post-FESS patients have significantly altered anatomy leading to markedly different flow dynamics from those found in pre-op or non-diseased airways, resulting in unknown flow dynamics. Methods This work investigated how the liquid stream disperses through altered nasal cavities following surgery using Computational Fluid Dynamics (CFD). A realistic squeeze profile was determined from physical experiments with a 27-year-old male using a squeeze bottle with load sensors. The administration technique involved a head tilt of 45-degrees forward to represent a head position over a sink. After the irrigation event that lasted 4.5 s, the simulation continued for an additional 1.5 s, with the head orientation returning to an upright position. Results The results demonstrated that a large maxillary sinus ostium on the right side allows saline penetration into this sinus. The increased volume of saline entering the maxillary sinus limits the saline volume available to the rest of the sinonasal cavity and reduces the surface coverage of the other paranasal sinuses. The average wall shear stress was higher on the right side than on the other side for two patients. The results also revealed that head position alters the sinuses’ saline residual, especially the frontal sinuses. Conclusion While greater access to sinuses is achieved through FESS surgery, patients without a nasal septum limits posterior sinus penetration due to the liquid crossing over to the contralateral cavity and exiting the nasal cavity early.

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Nasal saline irrigation – A review of current anatomical, clinical and computational modelling approaches

Cited by 12 publications

References 43 publications

Assessment of three types of intranasal nebulization devices in three‐dimensional printed models and volunteers: a pilot study

Assessment of three types of intranasal nebulization devices in three‐dimensional printed models and volunteers: a pilot study

Nasal irrigation delivery in three post-FESS models from a squeeze-bottle using CFD

Nasal Irrigation Delivery in Three Post-FESS Models From a Squeeze-bottle Using CFD

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