title: Delivery of nasal drops to the middle meatus: which is the best head position?
abstract: BACKGROUND
  Chronic sinusitis and intranasal polyps require long-term topical drug therapy. The issue of drug delivery to the critical area of the middle meatus is rarely addressed.
  
  
  OBJECTIVE
  The aim of this study was to compare the delivery of drops to the middle meatus using four different head positions (Mecca, Mygind, Ragan and Head back). The study also assessed the discomfort with each position whilst administering the nasal drops.
  
  
  METHODS
  Nine nostrils in five healthy volunteers were studied to compare the delivery of drops to the middle meatus using the four different head positions. A neurosurgical patty was placed under direct vision in the middle meatus using a rigid nasendoscope. Six drops of dyed-saline were administered into each nostril. Upon removal, a quantitative assessment was made of the amount of dye absorbed and discomfort assessed. The direction of flow of the nasal drops in the nose was also demonstrated.
  
  
  RESULTS
  The 'Mygind' and 'Ragan' positions were superior to the 'Mecca' and 'Head back' positions in delivery of drops to the middle meatus. The 'Mecca' position was the most uncomfortable.
  
  
  CONCLUSIONS
  We recommend that the 'Mygind' or 'Ragan' position should be used for nasal drop administration.
authors.affiliation: Department of Ear, Nose and Throat, Arrowe Park Hospital, Wirral, United Kingdom. gadzama@themail.co.uk
authors.forename: Y G
authors.initials: YG
authors.lastname: Karagama
authors.forename: J L
authors.initials: JL
authors.lastname: Lancaster
authors.forename: A
authors.initials: A
authors.lastname: Karkanevatos
authors.forename: G
authors.initials: G
authors.lastname: O'Sullivan
mesh_terms: D018592:Cross-Over Studies; D004724:Endoscopy; D006801:Humans; D019999:Pharmaceutical Solutions / Q000008:administration & dosage*; D011187:Posture; D011446:Prospective Studies
chemical_list: D019999:Pharmaceutical Solutions