Tags

Type your tag names separated by a space and hit enter

Particle deposition in the paranasal sinuses following endoscopic sinus surgery.
Comput Biol Med. 2020 01; 116:103573.CB

Abstract

Optimizing intranasal distribution and retention of topical therapy is essential in the management of patients with chronic rhinosinusitis, including those that have had functional endoscopic sinus surgery (FESS). Computational fluid dynamics analysis has not previously been used to investigate sinus nasal spray delivery in the complete post-operative sinonasal geometries of patients who have undergone FESS. Models of sinonasal cavities were created from postoperative magnetic resonance imaging scans in four patients, three of whom underwent a comprehensive FESS, the other a modified endoscopic Lothrop procedure. Spray simulations were conducted at different flow rates (5 L/min, 10 L/min and 15 L/min) using sixteen particle sizes ranging from 4 μm to 70μm, spray velocity of 10 m/s and plume angle of 15°. Two different spray insertion angles were compared. Airflow distribution in the sinuses was closely related to the patient's nasal geometry and surgical intervention, in particular a unique crossflow between nasal chambers was present for the Lothrop patient. Sinus deposition was generally more effective with inhalational transport of low-inertia particles outside of the range produced by many standard nasal sprays or nebulizer. This was true except in the Lothrop patient, since previous surgery had been performed removing most of the septum where high-inertia particles would normally deposit. For sinuses receiving minimal airflow, particle penetration was diminished and successful deposition in the region became more restricted by device parameters. Further research is needed to validate these findings and explore other spray variables in a wider spectrum of patients to ascertain a multi-level approach to optimizing drug delivery in the sinuses.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Siu J
Department of Surgery, The University of Auckland, Auckland, New Zealand.
Shrestha K
Mechanical & Automotive Engineering, School of Engineering, RMIT University, Bundoora, Victoria, 3083, Australia.
Inthavong K
Mechanical & Automotive Engineering, School of Engineering, RMIT University, Bundoora, Victoria, 3083, Australia. Electronic address: kiao.inthavong@rmit.edu.au.
Shang Y
Mechanical & Automotive Engineering, School of Engineering, RMIT University, Bundoora, Victoria, 3083, Australia.
Douglas R
Department of Surgery, The University of Auckland, Auckland, New Zealand. Electronic address: richard.douglas@auckland.ac.nz.

MeSH

Computer SimulationEndoscopyHumansNasal CavityParanasal SinusesSinusitis

Pub Type(s)

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

Language

eng

PubMed ID

31999554

Citation

Siu, Joey, et al. "Particle Deposition in the Paranasal Sinuses Following Endoscopic Sinus Surgery." Computers in Biology and Medicine, vol. 116, 2020, p. 103573.
Siu J, Shrestha K, Inthavong K, et al. Particle deposition in the paranasal sinuses following endoscopic sinus surgery. Comput Biol Med. 2020;116:103573.
Siu, J., Shrestha, K., Inthavong, K., Shang, Y., & Douglas, R. (2020). Particle deposition in the paranasal sinuses following endoscopic sinus surgery. Computers in Biology and Medicine, 116, 103573. https://doi.org/10.1016/j.compbiomed.2019.103573
Siu J, et al. Particle Deposition in the Paranasal Sinuses Following Endoscopic Sinus Surgery. Comput Biol Med. 2020;116:103573. PubMed PMID: 31999554.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Particle deposition in the paranasal sinuses following endoscopic sinus surgery. AU - Siu,Joey, AU - Shrestha,Kendra, AU - Inthavong,Kiao, AU - Shang,Yidan, AU - Douglas,Richard, Y1 - 2019/12/04/ PY - 2019/08/27/received PY - 2019/12/02/revised PY - 2019/12/02/accepted PY - 2020/1/31/entrez PY - 2020/1/31/pubmed PY - 2021/6/22/medline KW - Administration KW - CFD KW - Drug delivery systems KW - Intranasal KW - Nasal cavity KW - Nasal sprays KW - Paranasal sinuses KW - Simulation KW - Sinusitis KW - Topical SP - 103573 EP - 103573 JF - Computers in biology and medicine JO - Comput Biol Med VL - 116 N2 - Optimizing intranasal distribution and retention of topical therapy is essential in the management of patients with chronic rhinosinusitis, including those that have had functional endoscopic sinus surgery (FESS). Computational fluid dynamics analysis has not previously been used to investigate sinus nasal spray delivery in the complete post-operative sinonasal geometries of patients who have undergone FESS. Models of sinonasal cavities were created from postoperative magnetic resonance imaging scans in four patients, three of whom underwent a comprehensive FESS, the other a modified endoscopic Lothrop procedure. Spray simulations were conducted at different flow rates (5 L/min, 10 L/min and 15 L/min) using sixteen particle sizes ranging from 4 μm to 70μm, spray velocity of 10 m/s and plume angle of 15°. Two different spray insertion angles were compared. Airflow distribution in the sinuses was closely related to the patient's nasal geometry and surgical intervention, in particular a unique crossflow between nasal chambers was present for the Lothrop patient. Sinus deposition was generally more effective with inhalational transport of low-inertia particles outside of the range produced by many standard nasal sprays or nebulizer. This was true except in the Lothrop patient, since previous surgery had been performed removing most of the septum where high-inertia particles would normally deposit. For sinuses receiving minimal airflow, particle penetration was diminished and successful deposition in the region became more restricted by device parameters. Further research is needed to validate these findings and explore other spray variables in a wider spectrum of patients to ascertain a multi-level approach to optimizing drug delivery in the sinuses. SN - 1879-0534 UR - https://www.unboundmedicine.com/medline/citation/31999554/Particle_deposition_in_the_paranasal_sinuses_following_endoscopic_sinus_surgery_ DB - PRIME DP - Unbound Medicine ER -