title: Sonic aerosol therapy to target maxillary sinuses.
abstract: OBJECTIVE
  Intranasal aerosol administration of drugs is widely used by ENT specialists. Although clinical evidence is still lacking, intranasal nebulization appears to be an interesting therapeutic option for local drug delivery, targeting anatomic sites beyond the nasal valve. The sonic nebulizer NL11SN associates a 100Hertz (Hz) sound to the aerosolization to improve deposition in the nasal/paranasal sinuses. The aim of the present study was: to evaluate in vivo the influence of associating a 100Hz sound on sinus ventilation and nasal and pulmonary aerosol deposition in normal volunteers, and; to quantify in vitro aerosol deposition in the maxillary sinuses in a plastinated head model.
  
  
  METHODS
  Scintigraphic analysis of (81m)Kr gas ventilation and of sonic aerosol ((99m)Tc-DTPA) deposition using the NL11SN was performed in vivo in seven healthy volunteers. In parallel, NL11SN gentamicin nebulization was performed, with or without associated 100Hz sound, in a plastinated human head model; the gross amount of gentamicin delivered to the paranasal sinuses was determined by fluorescence polarization immunoassay.
  
  
  RESULTS
  Associating the 100Hz sound to (81m)Kr gas ensured paranasal sinus ventilation in healthy volunteers. (99m)Tc-DTPA particles nebulized with the NL11SN were deposited predominantly in the nasal cavities (2/3, vs 1/3 in the lungs). In vitro, the use of NL11SN in sonic mode increased gentamicin deposition threefold in the plastinated model sinuses (P<0.002); the resulting antibiotic deposit would be sufficient to induce a local therapeutic effect.
  
  
  CONCLUSIONS
  The NL11SN nebulizer ensured preferential nasal cavity aerosol deposition and successfully targeted the maxillary sinuses.
authors.affiliation: Service d'ORL et chirurgie cervico-faciale, centre hospitalier Émile-Roux, Le Puy-en-Velay, France. marc.durand@ch-lepuy.fr
authors.forename: M
authors.initials: M
authors.lastname: Durand
authors.forename: S
authors.initials: S
authors.lastname: Le Guellec
authors.forename: J
authors.initials: J
authors.lastname: Pourchez
authors.forename: F
authors.initials: F
authors.lastname: Dubois
authors.forename: G
authors.initials: G
authors.lastname: Aubert
authors.forename: G
authors.initials: G
authors.lastname: Chantrel
authors.forename: L
authors.initials: L
authors.lastname: Vecellio
authors.forename: C
authors.initials: C
authors.lastname: Hupin
authors.forename: R
authors.initials: R
authors.lastname: De Gersem
authors.forename: G
authors.initials: G
authors.lastname: Reychler
authors.forename: L
authors.initials: L
authors.lastname: Pitance
authors.forename: P
authors.initials: P
authors.lastname: Diot
authors.forename: F
authors.initials: F
authors.lastname: Jamar
mesh_terms: D000328:Adult; D000465:Algorithms; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D005839:Gentamicins / Q000008:administration & dosage*; D064368:Healthy Volunteers; D006801:Humans; D008297:Male; D008443:Maxillary Sinus / Q000000981:diagnostic imaging / Q000187:drug effects*; D008953:Models, Anatomic; D009296:Nasal Cavity / Q000000981:diagnostic imaging / Q000187:drug effects*; D059085:Nasal Sprays; D009330:Nebulizers and Vaporizers; D010256:Paranasal Sinuses / Q000187:drug effects; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D013010:Sonication / Q000379:methods; D016284:Technetium Tc 99m Pentetate
chemical_list: D000900:Anti-Bacterial Agents; D005839:Gentamicins; D059085:Nasal Sprays; D019275:Radiopharmaceuticals; D016284:Technetium Tc 99m Pentetate