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Optimizing topical delivery to the ostiomeatal complex after functional endoscopic sinus surgery using a

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Optimizing nasal drug delivery for chronic rhinosinusitis with nasal polyps (CRSwNP) is crucial. Adjusting the device nosepiece angle significantly improves medication deposition in the ostiomeatal complex (OMC).

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Area of Science:

  • Biomedical Engineering
  • Respiratory Medicine
  • Pharmacology

Background:

  • Chronic rhinosinusitis with nasal polyps (CRSwNP) presents treatment challenges due to recurrent disease after surgery.
  • Inadequate drug delivery to the posterior nasal mucosa, especially the ostiomeatal complex (OMC), contributes to CRSwNP recurrence.
  • Understanding aerosol dynamics is key to improving intranasal drug deposition, but quantitative assessment in complex anatomies is difficult.

Purpose of the Study:

  • To investigate the impact of device parameters and airflow on intranasal drug deposition, particularly in the OMC for CRSwNP treatment.
  • To develop and validate a computational model for evaluating nasal drug delivery systems.
  • To identify optimal strategies for enhancing drug delivery to target regions within the sinonasal cavity.

Main Methods:

  • Utilized computational fluid dynamics (CFD) simulations on patient-specific sinonasal models.
  • Incorporated realistic polydisperse particle size distributions and bidirectional delivery.
  • Validated simulation results against in vitro experiments using 3D-printed nasal replicas.

Main Results:

  • Lateral adjustment of the nosepiece insertion angle significantly improved OMC drug deposition.
  • Particle sizes ≤15.5 μm and ≥52.5 μm demonstrated greater OMC deposition compared to mid-sized particles.
  • Exhalation flow rate (15-45 L/min) positively correlated with total OMC mass deposition; nosepiece wall thickness had minor effects.

Conclusions:

  • Nosepiece insertion orientation is a critical factor for optimizing regional nasal drug delivery.
  • Particle size and airflow dynamics play nuanced roles in drug deposition within the sinonasal cavity.
  • This study provides a framework for designing more effective nasal drug delivery systems for CRSwNP.