Delivering Therapy to the Olfactory Cleft: A Comparison of the Various Methods of Administering Topical Nasal Medications.

Autor:	Jacobson PT; Department of Otolaryngology-Head and Neck Surgery, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, USA., Axiotakis LG Jr; Department of Otolaryngology-Head and Neck Surgery, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, USA., Vilarello BJ; Otolaryngology, Vagelos College of Physicians and Surgeons, Columbia University, New York, USA., Gudis DA; Department of Otolaryngology-Head and Neck Surgery, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, USA., Spielman DB; Department of Otolaryngology-Head and Neck Surgery, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, USA.; Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, Atlanta, USA., Yang N; Department of Otolaryngology-Head and Neck Surgery, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, USA., Yan CH; Department of Otolaryngology-Head and Neck Surgery, The University of California, San Diego School of Medicine, La Jolla, USA., Soler ZM; Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Mt. Pleasant, USA., Levy JM; Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, Atlanta, USA., Rowan NR; Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, USA., Irace AL; Department of Otolaryngology-Head and Neck Surgery, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, USA., Overdevest JB; Department of Otolaryngology-Head and Neck Surgery, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, USA.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Feb 03; Vol. 16 (2), pp. e53523. Date of Electronic Publication: 2024 Feb 03 (Print Publication: 2024).
DOI:	10.7759/cureus.53523
Abstrakt:	Background and objective Chronic rhinosinusitis (CRS) is an inflammatory condition affecting the nasal mucosa, and it causes olfactory dysfunction (OD) in up to 78.2% of patients. Corticosteroids are the mainstay of treatment to shrink nasal polyposis, reduce inflammation, and improve olfactory function. While many delivery methods for topical nasal corticosteroids exist, there is scarce data on the efficacy of the various medication delivery methods to the olfactory cleft (OC). In light of this, this study aimed to compare the following delivery methods to the OC: conventional nasal spray (NS), nasal drops in the Kaiteki position (KP), and exhalation delivery system (EDS). Methods We evaluated 16 sinonasal cavities from eight cadaver specimens in this study. Each sinonasal cavity was administered fluorescein dye solution via NS, KP, and EDS. Following administration, nasal endoscopy was employed to capture staining patterns in the OC. OC staining was rated with scores ranging from 0 (no staining) to 3 (heavy staining) after each administration of dye solution. Mean OC staining ratings were calculated and compared using the Kruskal-Wallis rank sum test and the Wilcoxon signed-rank test. Results The mean OC staining score for the different delivery methods was as follows - NS: 1.095 ± 1.008, EDS: 0.670 ± 0.674, and KP: 2.038 ± 1.097. Nasal drops in the KP had a significantly higher staining score compared to NS (p=0.041) and EDS (p=0.003). However, there was no significant difference in staining scores between NS and EDS. Conclusions Nasal drops in the KP are more effective at reaching the OC than NS or EDS and should be considered as a first-line modality for administering topical medications when treating OD. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2024, Jacobson et al.)
Databáze:	MEDLINE
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