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RESEARCH ARTICLE
Abstract
Objectives
Chronic rhinosinusitis (CRS) is a common chronic disease of the upper airways and has considerable impact on quality of life. Topical delivery of drugs to the paranasal sinuses is challenging, therefore the rate of surgery is high. This study investigates the delivery efficiency of a pulsating aerosol in comparison to a nasal pump spray to the sinuses and the nose in healthy volunteers and in CRS patients before and after sinus surgery.
Methods
99mTc-DTPA pulsating aerosols were applied in eleven CRSsNP patients without nasal polyps before and after sinus surgery. In addition, pulsating aerosols were studied in comparison to nasal pump sprays in eleven healthy volunteers. Total nasal and frontal, maxillary and sphenoidal sinus aerosol deposition and lung penetration were assessed by anterior and lateral planar gamma camera imaging.
Results
In healthy volunteers nasal pump sprays resulted in 100% nasal, non-significant sinus and lung deposition, while pulsating aerosols resulted 61.3+/-8.6% nasal deposition and 38.7% exit the other nostril. 9.7+/-2.0 % of the nasal dose penetrated into maxillary and sphenoidal sinuses. In CRS patients, total nasal deposition was 56.7+/-13.3% and 46.7+/-12.7% before and after sinus surgery, respectively (p<0 .01="" 4.8="" 8.2="" accordingly="" and="" crs="" deposition="" dose="" frontal="" healthy="" in="" maxillary="" nasal="" neither="" nor="" of="" p="" patients="" significant="" sinus="" sinuses.="" sphenoidal="" the="" there="" volunteers="" was="">
Conclusion
In contrast to nasal pump sprays, pulsating aerosols can deliver significant doses into posterior nasal spaces and paranasal sinuses, providing alternative therapy options before and after sinus surgery. Patients with chronic lung diseases based on clearance dysfunction may also benefit from pulsating aerosols, since these diseases also manifest in the upper airways.
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Citation:
Möller W, Schuschnig U, Celik G, Münzing W, Bartenstein P, et al. (2013) Topical Drug Delivery in Chronic Rhinosinusitis Patients before and after Sinus Surgery Using Pulsating Aerosols. PLoS ONE 8(9): e74991. doi:10.1371/journal.pone.0074991
Editor: Noam A. Cohen, Hospital of the University of Pennsylvania, United States of America
Received: December 5, 2012; Accepted: August 8, 2013; Published: September 11, 2013
Copyright: © 2013 Möller et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Funding: The study was supported by research grants from Pari GmbH, Starnberg, Germany and from the Bavarian Research foundation (AZ-914-10). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing interests: The study was in part supported by research grants from Pari GmbH, Starnberg, Germany. US and MK are employees of Pari GmbH, Starnberg, Germany, and Pari provided the Vibrent pulsating aerosol devices during the study. The funding did not influence the data collection, data analysis and results, nor data interpretation. All authors except US and MK (Pari employees) are not involved in consultancy, patents, products in development or marketed products of the funder Pari GmbH. Funding by Pari GmbH does not alter the authors' adherence to all the PLOS ONE policies on sharing data and materials, as detailed online in PLOS ONE's guide for authors. All other authors have declared that no competing interests exist.
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