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Computed intranasal spray penetration: comparisons before and after nasal surgery. Int Forum Allergy Rhinol 2013 Jan;3(1):48-55



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BACKGROUND: Quantitative methods for comparing intranasal drug delivery efficiencies pre- and postoperatively have not been fully utilized. The objective of this study is to use computational fluid dynamics techniques to evaluate aqueous nasal spray penetration efficiencies before and after surgical correction of intranasal anatomic deformities.

METHODS: Ten three-dimensional models of the nasal cavities were created from pre- and postoperative computed tomography scans in 5 subjects. Spray simulations were conducted using a particle size distribution ranging from 10 μm to 110 μm, a spray speed of 3 m/second, plume angle of 68 degrees, and with steady state, resting inspiratory airflow present. Two different nozzle positions were compared. Statistical analysis was conducted using Student t test for matched pairs.

RESULTS: On the obstructed side, posterior particle deposition after surgery increased by 118% and was statistically significant (p = 0.036), while anterior particle deposition decreased by 13% and was also statistically significant (p = 0.020). The fraction of particles that bypassed the airways either pre- or postoperatively was less than 5%. Posterior particle deposition differences between obstructed and contralateral sides of the airways were 113% and 30% for pre- and postsurgery, respectively. Results showed that nozzle positions can influence spray delivery.

CONCLUSION: Simulations predicted that surgical correction of nasal anatomic deformities can improve spray penetration to areas where medications can have greater effect. Particle deposition patterns between both sides of the airways are more evenly distributed after surgery. These findings suggest that correcting anatomic deformities may improve intranasal medication delivery. For enhanced particle penetration, patients with nasal deformities may explore different nozzle positions.

Author List

Frank DO, Kimbell JS, Cannon D, Rhee JS


John S. Rhee MD Chair, Professor in the Otolaryngology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Administration, Intranasal
Computer Simulation
Imaging, Three-Dimensional
Middle Aged
Models, Anatomic
Models, Biological
Nasal Cavity
Nasal Sprays
Nasal Surgical Procedures
Tomography, X-Ray Computed
Treatment Outcome
jenkins-FCD Prod-478 d1509cf07a111124a2d122fd3df854cc0b993c00