title: Computed intranasal spray penetration: comparisons before and after nasal surgery.
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of North Carolina, Chapel Hill, NC 27599, USA. dennis_frank@med.unc.edu
authors.forename: Dennis O
authors.initials: DO
authors.lastname: Frank
authors.forename: Julia S
authors.initials: JS
authors.lastname: Kimbell
authors.forename: Daniel
authors.initials: D
authors.lastname: Cannon
authors.forename: John S
authors.initials: JS
authors.lastname: Rhee
mesh_terms: D000281:Administration, Intranasal / Q000379:methods*; D000328:Adult; D000336:Aerosols / Q000493:pharmacokinetics*; D003198:Computer Simulation; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D008953:Models, Anatomic; D008954:Models, Biological; D009296:Nasal Cavity / Q000000981:diagnostic imaging / Q000502:physiology*; D059085:Nasal Sprays; D059747:Nasal Surgical Procedures; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
chemical_list: D000336:Aerosols; D059085:Nasal Sprays