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Drug delivery in the nasal cavity after functional endoscopic sinus surgery: a computational fluid dynamics study

Published online by Cambridge University Press:  14 March 2012

X B Chen ,
H P Lee ,
V F H Chong  and
D Y Wang
X B Chen
Affiliation:
Department of Mechanical Engineering, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
H P Lee
Affiliation:
Department of Mechanical Engineering, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
V F H Chong
Affiliation:
Department of Diagnostic Radiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
D Y Wang*
Affiliation:
Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
*
Address for correspondence: Dr De Yun Wang, Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, 5 Lower Kent Ridge Road, Singapore 119260 Fax: +65 67753820 E-mail: [email protected]
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Abstract

Background:

Intranasal medication is commonly used for nasal disease. However, there are no clear specifications for intranasal medication delivery after functional endoscopic sinus surgery.

Methods:

A three-dimensional model of the nasal cavity was constructed from computed tomography scans of an adult Chinese male who had previously undergone functional endoscopic sinus surgery in the right nasal cavity. Computational fluid dynamic simulations modelled airflow and particle deposition, based on discrete phase models.

Results:

In the right nasal cavity, more particles passed through the upper dorsal region, around the surgical area, and streamed into the right maxillary sinus region. In the left cavity, particles were distributed more regularly and uniformly in the ventral region around the inferior turbinate. A lower inspiratory airflow rate and smaller initial particle velocity assisted particle deposition within the right maxillary sinus cavity. In the right nasal cavity, the optimal particle diameter was approximately 10−5 m for maxillary sinus cavity deposition and 3 × 10−6 m for bottom region deposition. In the right nasal cavity, altered back head tilt angles enhanced particle deposition in the top region of the surgical area, and altered right side head tilt angles helped enhance maxillary sinus cavity deposition.

Conclusion:

This model indicates that a moderate inspiratory airflow rate and a particle diameter of approximately 10−5 m should improve intranasal medication deposition into the maxillary sinus cavity following functional endoscopic sinus surgery.

Keywords

Drug Administration, TopicalNasal CavityParanasal SinusesFluid Dynamics
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 126 , Issue 5 , May 2012 , pp. 487 - 494
Copyright
Copyright © JLO (1984) Limited 2012

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References

1Stammberger, H, Posawetz, W. Functional endosopic sinus surgery – concept, indications and results of the Messerklinger technique. Eur Arch Otorhinolaryngol 1990;247:63–76Google Scholar
2Tan, BK, Lane, AP. Endoscopic sinus surgery in the management of nasal obstruction. Otolaryngol Clin North Am 2009;42:227–40CrossRefGoogle ScholarPubMed
3Vaughan, WC, Carvalho, G. Use of nebulized antibiotics for acute infections in chronic sinusitis. Otolaryngol Head Neck Surg 2002;126:558–68CrossRefGoogle Scholar
4Hyo, N, Takano, H, Hyo, Y. Particle deposition efficiency of therapeutic aerosols in the human maxillary sinus. Rhinology 1989;27:17–26Google ScholarPubMed
5Hilton, C, Wiedmann, T, Martin, MS, Humphrey, B, Schleiffarth, R, Rimell, F. Differential deposition of aerosols in the maxillary sinus of human cadavers by particle size. Am J Rhinol 2008;22:395–8CrossRefGoogle ScholarPubMed
6Senocak, D, Senocak, M, Bozan, S. Sinonasal distribution of topically applied particles: computerized tomographic detection and the effects of topical decongestion. Otolaryngol Head Neck Surg 2005;133:944–8CrossRefGoogle ScholarPubMed
7Homer, JJ, Maughan, J, Burniston, M. A quantitative analysis of the intranasal delivery of topical nasal drugs to the middle meatus: spray versus drop administration. J Laryngol Otol 2002;116:10–13CrossRefGoogle Scholar
8Dowley, AC, Homer, JJ. The effect of inferior turbinate hypertrophy on nasal spray distribution to the middle meatus. Clin Otolaryngol Allied Sci 2001;26:488–90CrossRefGoogle Scholar
9Merkus, P, Ebbens, FA, Muller, B, Fokkens, WJ. The ‘best method’ of topical nasal drug delivery: comparison of seven techniques. Rhinology 2005;43:102–7Google Scholar
10Kimbell, JS, Segal, RA, Asgharian, B, Wong, BA, Schroeter, JD, Southall, JP et al. Characterization of deposition from nasal spray devices using a computational fluid dynamics model of the human nasal passages. J Aerosol Med 2007;20:59–74CrossRefGoogle ScholarPubMed
11Inthavong, K, Tian, ZF, Tu, JY, Yang, W. Optimising nasal spray parameters for efficient drug delivery using CFD. Comput Biol Med 2008;38:713–26CrossRefGoogle Scholar
12Shi, H, Kleinstreuer, C, Zhang, Z. Laminar airflow and nanoparticle or vapor deposition in a human nasal cavity model. J Biomech Eng 2006;128:697–706CrossRefGoogle ScholarPubMed
13Liu, Y, Edgar, AM, Gu, JJ, Matthew, RJ. Numerical simulation of aerosol deposition in a 3-D human nasal cavity using RANS, RANS/EIM, and LES. J Aerosol Sci 2007;38:683–700CrossRefGoogle Scholar
14Xi, JX, Longest, PW. Numerical predictions of submicrometer aerosol deposition in the nasal cavity using a novel drift flux approach. Int J Heat Mass Transfer 2008;51:5562–77CrossRefGoogle Scholar
15Inthavong, K, Tian, ZF, Li, HF, Tu, JY, Yang, W, Xue, CL et al. A numerical study of spray particle deposition in a human nasal cavity. Aerosol Sci Technol 2006;40:1034–45CrossRefGoogle Scholar
16Shanley, KT, Zamankhan, P, Ahmadi, G, Hopke, PK, Cheng, YS. Numerical simulations investigating the regional and overall deposition efficiency of the human nasal cavity. Inhal Toxicol 2008;20:1093–100CrossRefGoogle ScholarPubMed
17Zhao, K, Pribitkin, EA, Cowart, BJ, Rosen, D, Scherer, PW, Dalton, P. Numerical modeling of nasal obstruction and endoscopic surgical intervention: outcome to airflow and olfaction. Am J Rhinol 2006;20:308–16CrossRefGoogle ScholarPubMed
18Xiong, GX, Zhan, JM, Jiang, HY, Li, JF, Rong, LW, Xu, G. Numerical flow simulation in the post-endoscopic sinus surgery nasal cavity. Med Biol Eng Comput 2008;46:1161–7CrossRefGoogle ScholarPubMed
19Chen, XB, Lee, HP, Chong, VFH, Wang, DY. Assessment of septal deviation effects on nasal air flow: a computational fluid dynamics model. Laryngoscope 2009;119:1730–6CrossRefGoogle Scholar
20Chen, XB, Lee, HP, Chong, VFH, Wang, DY. Impact of inferior turbinate hypertrophy on the aerodynamic pattern and physiological functions of the turbulent airflow – a CFD simulation model. Rhinology 2010;48:163–8Google ScholarPubMed
21Chen, XB, Leong, SC, Lee, HP, Chong, VFH, Wang, DY. Aerodynamic effects of inferior turbinate surgery on nasal airflow – a computational fluid dynamics model. Rhinology 2010;48:394–400CrossRefGoogle ScholarPubMed
22Chen, XB, Lee, HP, Chong, VF, Wang, DY. A computational fluid dynamics model for drug delivery in a nasal cavity with inferior turbinate hypertrophy. J Aerosol Med Pulm Drug Del 2010; 23: 329–38CrossRefGoogle Scholar
23Chen, XB, Lee, HP, Chong, VFH, Wang, DY. Effects of functional endoscopic sinus surgery on nasal air flow – a computational fluid dynamics study. In: Lim, C.T., Goh, J.C.H.. 6th World Congress on Biomechanics, 1 – 6 August, 2010. Singapore: 1. Edition, Springer-Verlag, 2010Google Scholar
24Moss, RB, King, VV. Management of sinusitis in cystic fibrosis by endoscopic surgery and serial antimicrobial lavage: reduction in recurrence requiring surgery. Arch Otolaryngol Head Neck Surg 1995;121:566–72CrossRefGoogle ScholarPubMed
25Hwang, PH, Woo, RJ, Fong, KJ. Intranasal deposition of nebulized saline: a radionuclide distribution study. Am J Rhinol 2007;20:255–61CrossRefGoogle Scholar
26Nayak, DR, Balakrishnan, R. De novo bacterial reinfections after endoscopic sinus surgery: can uncinate process preservation surgeries prevent it? Laryngoscope 2005;115:928CrossRefGoogle Scholar
27Bhattacharyya, N, Gopal, HV, Lee, KH. Bacterial infection after endoscopic sinus surgery: a controlled prospective study. Laryngoscope 2004;114:765–7CrossRefGoogle ScholarPubMed
28Bhattacharyya, N. Response. De novo bacterial reinfections after endoscopic sinus surgery: can uncinate process preservation surgeries prevent it? Laryngoscope 2005;115:928–9CrossRefGoogle Scholar
29Schroeter, JD, Kimbell, JS, Asgharian, B. Analysis of particle deposition in the turbinate and olfactory regions using a human nasal computational fluid dynamics model. J Aerosol Med 2006;19:301–13CrossRefGoogle ScholarPubMed