Pulsating airflow and drug delivery to paranasal sinuses

Purpose of reviewThere is a high incidence of nasal disorders, including chronic rhinosinusitis (CRS), affecting about 14% of the total population. Topical treatment regimens show only limited efficacy of drug delivery to the posterior nose and paranasal sinuses. Nevertheless, the primary treatment option of CRS is a combination of topical or systemic steroids, antibiotics and functional endonasal sinus surgery (FESS). Recent findingsSinus ventilation and paranasal aerosol deposition can be achieved by using pulsating airflow. Studies using pulsating airflow in nasal casts and in healthy volunteers have shown that up to 8% of the nasally deposited drug can deposit within the sinuses, which could not be achieved using nasal pump sprays. In addition, compared with nasal pump sprays, retention kinetics of the radiolabel deposit in the nose was prolonged. SummaryWith this efficiency, topical aerosol therapies of sinus disorders can be achieved and, due to the prolonged retention, reduced application modes are possible. This offers new treatment options of sinus–nasal disorders prior or after FESS.

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