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Topical drug delivery in chronic rhinosinusitis patients before and after sinus surgery using pulsating aerosols.
PLoS One. 2013; 8(9):e74991.Plos

Abstract

OBJECTIVES

Chronic rhinosinusitis (CRS) is a common chronic disease of the upper airways and has considerable impact on quality of life. Topical delivery of drugs to the paranasal sinuses is challenging, therefore the rate of surgery is high. This study investigates the delivery efficiency of a pulsating aerosol in comparison to a nasal pump spray to the sinuses and the nose in healthy volunteers and in CRS patients before and after sinus surgery.

METHODS

(99m)Tc-DTPA pulsating aerosols were applied in eleven CRSsNP patients without nasal polyps before and after sinus surgery. In addition, pulsating aerosols were studied in comparison to nasal pump sprays in eleven healthy volunteers. Total nasal and frontal, maxillary and sphenoidal sinus aerosol deposition and lung penetration were assessed by anterior and lateral planar gamma camera imaging.

RESULTS

In healthy volunteers nasal pump sprays resulted in 100% nasal, non-significant sinus and lung deposition, while pulsating aerosols resulted 61.3+/-8.6% nasal deposition and 38.7% exit the other nostril. 9.7+/-2.0 % of the nasal dose penetrated into maxillary and sphenoidal sinuses. In CRS patients, total nasal deposition was 56.7+/-13.3% and 46.7+/-12.7% before and after sinus surgery, respectively (p<0.01). Accordingly, maxillary and sphenoidal sinus deposition was 4.8+/-2.2% and 8.2+/-3.8% of the nasal dose (p<0.01). Neither in healthy volunteers nor in CRS patients there was significant dose in the frontal sinuses.

CONCLUSION

In contrast to nasal pump sprays, pulsating aerosols can deliver significant doses into posterior nasal spaces and paranasal sinuses, providing alternative therapy options before and after sinus surgery. Patients with chronic lung diseases based on clearance dysfunction may also benefit from pulsating aerosols, since these diseases also manifest in the upper airways.

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Authors+Show Affiliations

Möller W
Institute for Lung Biology and Disease (iLBD), Helmholtz Zentrum München, Neuherberg, Germany.
Schuschnig U
No affiliation info available
Celik G
No affiliation info available
Münzing W
No affiliation info available
Bartenstein P
No affiliation info available
Häussinger K
No affiliation info available
Kreyling WG
No affiliation info available
Knoch M
No affiliation info available
Canis M
No affiliation info available
Becker S
No affiliation info available

MeSH

Administration, IntranasalAdultAerosolsCase-Control StudiesDrug Delivery SystemsFemaleHumansMagnetic Resonance ImagingMaleMiddle AgedNasal PolypsNasal SpraysParanasal SinusesSinusitisTechnetium Tc 99m PentetateTomography, X-Ray Computed

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24040372

Citation

Möller, Winfried, et al. "Topical Drug Delivery in Chronic Rhinosinusitis Patients Before and After Sinus Surgery Using Pulsating Aerosols." PloS One, vol. 8, no. 9, 2013, pp. e74991.
Möller W, Schuschnig U, Celik G, et al. Topical drug delivery in chronic rhinosinusitis patients before and after sinus surgery using pulsating aerosols. PLoS One. 2013;8(9):e74991.
Möller, W., Schuschnig, U., Celik, G., Münzing, W., Bartenstein, P., Häussinger, K., Kreyling, W. G., Knoch, M., Canis, M., & Becker, S. (2013). Topical drug delivery in chronic rhinosinusitis patients before and after sinus surgery using pulsating aerosols. PloS One, 8(9), e74991. https://doi.org/10.1371/journal.pone.0074991
Möller W, et al. Topical Drug Delivery in Chronic Rhinosinusitis Patients Before and After Sinus Surgery Using Pulsating Aerosols. PLoS One. 2013;8(9):e74991. PubMed PMID: 24040372.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Topical drug delivery in chronic rhinosinusitis patients before and after sinus surgery using pulsating aerosols. AU - Möller,Winfried, AU - Schuschnig,Uwe, AU - Celik,Gülnaz, AU - Münzing,Wolfgang, AU - Bartenstein,Peter, AU - Häussinger,Karl, AU - Kreyling,Wolfgang G, AU - Knoch,Martin, AU - Canis,Martin, AU - Becker,Sven, Y1 - 2013/09/11/ PY - 2012/12/05/received PY - 2013/08/08/accepted PY - 2013/9/17/entrez PY - 2013/9/17/pubmed PY - 2014/7/2/medline SP - e74991 EP - e74991 JF - PloS one JO - PLoS One VL - 8 IS - 9 N2 - OBJECTIVES: Chronic rhinosinusitis (CRS) is a common chronic disease of the upper airways and has considerable impact on quality of life. Topical delivery of drugs to the paranasal sinuses is challenging, therefore the rate of surgery is high. This study investigates the delivery efficiency of a pulsating aerosol in comparison to a nasal pump spray to the sinuses and the nose in healthy volunteers and in CRS patients before and after sinus surgery. METHODS: (99m)Tc-DTPA pulsating aerosols were applied in eleven CRSsNP patients without nasal polyps before and after sinus surgery. In addition, pulsating aerosols were studied in comparison to nasal pump sprays in eleven healthy volunteers. Total nasal and frontal, maxillary and sphenoidal sinus aerosol deposition and lung penetration were assessed by anterior and lateral planar gamma camera imaging. RESULTS: In healthy volunteers nasal pump sprays resulted in 100% nasal, non-significant sinus and lung deposition, while pulsating aerosols resulted 61.3+/-8.6% nasal deposition and 38.7% exit the other nostril. 9.7+/-2.0 % of the nasal dose penetrated into maxillary and sphenoidal sinuses. In CRS patients, total nasal deposition was 56.7+/-13.3% and 46.7+/-12.7% before and after sinus surgery, respectively (p<0.01). Accordingly, maxillary and sphenoidal sinus deposition was 4.8+/-2.2% and 8.2+/-3.8% of the nasal dose (p<0.01). Neither in healthy volunteers nor in CRS patients there was significant dose in the frontal sinuses. CONCLUSION: In contrast to nasal pump sprays, pulsating aerosols can deliver significant doses into posterior nasal spaces and paranasal sinuses, providing alternative therapy options before and after sinus surgery. Patients with chronic lung diseases based on clearance dysfunction may also benefit from pulsating aerosols, since these diseases also manifest in the upper airways. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/24040372/Topical_drug_delivery_in_chronic_rhinosinusitis_patients_before_and_after_sinus_surgery_using_pulsating_aerosols_ L2 - https://dx.plos.org/10.1371/journal.pone.0074991 DB - PRIME DP - Unbound Medicine ER -