Comparison of intranasal medication delivery devices before and after functional endoscopic sinus surgery using Phacon sinus surgery models

J Laryngol Otol. 2024 Mar;138(3):310-314. doi: 10.1017/S0022215123001226. Epub 2023 Jul 18.

Abstract

Objective: Functional endoscopic sinus surgery for chronic rhinosinusitis improves sinus drainage and intranasal medication delivery. This study compares medication delivery with commonly used devices in normal and altered anatomy (post functional endoscopic sinus surgery) using sinus surgery models (Phacon).

Methods: Medication delivery was simulated via nasal drops, nasal spray and an irrigation device (Neilmed Sinus Rinse). Coverage was then calculated from endoscopic pictures taken at various anatomical sites in the normal nose and post functional endoscopic sinus surgery.

Results: In the normal nose, nasal spray did not penetrate the sphenoid sinus, and drops bypassed the vestibule anteriorly. Neilmed Sinus Rinse provided superior coverage at the sphenoid site following sphenoidectomy and the frontal site following Draf III. After ethmoidectomy, nasal drops overall provided less coverage than the other methods.

Conclusion: Neilmed Sinus Rinse generally provided the best distribution, followed by the nasal spray and then nasal drops. The type and extent of surgery also affects medication delivery.

Keywords: Intranasal drug administration; nasal irrigation; nasal spray; paranasal sinuses.

MeSH terms

  • Chronic Disease
  • Endoscopy
  • Humans
  • Nasal Sprays
  • Paranasal Sinuses* / surgery
  • Rhinitis* / drug therapy
  • Rhinitis* / surgery
  • Sinusitis* / drug therapy
  • Sinusitis* / surgery
  • Sphenoid Sinus

Substances

  • Nasal Sprays