Prospective evaluation of aerosol delivery by a powered nasal nebulizer in the cadaver model

Abstract

The nebulizer consistently delivered aerosolized saline to multiple nasal subsites, with improvement in delivery seen to the middle meatal region after FESS and F-NEO after FESS with EML. This may have important implications for the delivery of topical medications to the paranasal sinuses in the postoperative setting.

Frontal sinus surgery and sinus distribution of nasal irrigation

“…In general, unoperated sinuses appear to receive little topical therapy, whereas more extensive procedures result in increasing distribution. [8][9][10][11] Specifically, a minimum of 4 mm to 5 mm ostial size has been shown to predict sinus penetration with high-volume devices. 8 Delivery appears best achieved with large volume devices.…”

International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

“…Unoperated sinuses appeared to receive little topical therapy, with more extensive procedures resulting in increasing distribution in general. 774,[808][809][810] Specifically, a 4-mm to 5-mm ostial size has been shown to predict sinus penetration with high volume irrigators. 774 Standard sinus surgery increases distribution of topical therapies to all sinuses, but has no impact upon nasal cavity delivery.…”

“…774 Standard sinus surgery increases distribution of topical therapies to all sinuses, but has no impact upon nasal cavity delivery. 809,810 Although there are both direct and indirect costs surrounding surgical intervention, there is a preponderance of benefit over harm to improve delivery of local topical therapies and avoid systemic therapies. 806 The Influence of Delivery Device.…”

Nasal saline irrigation: a clinical update

“…A wide variety of nasal saline delivery products are commercially available, including low‐volume, high‐volume, powered high‐pressure, and powered nebulized devices. Several studies have evaluated factors (extent of surgery, head position, and type of delivery device) with the potential to impact irrigation penetration into the paranasal sinuses . NSI has minimal sinus penetrance in patients who have not undergone surgery, but is positively correlated with the extent of functional endoscopic sinus surgery (FESS) .…”