Comparative investigation of transport and deposition of nebulized particles in nasal airways following various middle turbinectomy

作者：R. Ma, Long Tian, Yu Wang, Shoujia Sun, Jiaxiang Zhang, Min Lou, Zhenzhen Hu, Mengyan Gong, Fan Yang, Guoxi Zheng, J. Dong, Ya Zhang · 发表于：Rhinology Journal · 年份：2023 · DOI：10.4193/rhin23.265 · 被引用次数：9 · 研究领域：Sinusitis and nasal conditions、Inhalation and Respiratory Drug Delivery、Advanced Drug Delivery Systems

BACKGROUND: Topical intranasal medication is required following functional endoscopic sinus surgery (FESS). The optimal particle size of transnasal nebulization aimed at the sinonasal cavities is not conclusive. The current study aims to evaluate the effect of particle size and various surgery scope of middle turbinectomy (MT) on post-full FESS drug delivery to the sinonasal cavities. METHODS: Sinonasal reconstructions were performed from post-full FESS CT scans in 6 chronic rhinosinusitis with nasal polyps (CRSwNP) patients. Four additional models representing alternative surgery scopes of MT were established from each post-FESS reconstruction for simulation data comparison. Airflow and particle deposition of nebulized delivery were simulated via computational fluid dynamics (CFD) and validated through in vitro experiments. The optimal particle sizes reaching a deposition of at least 75% of the maximum in the targeted regions were identified. RESULTS: The drug deposition rate onto the targeted regions increased following MT, with the greatest deposition following posterior MT (P-MT). Droplets in the range of 18-26 μm reached a deposition of larger than 75% of the maximum onto the targeted regions. Drug delivery rate in the sinonasal cavities varied significantly among individuals and across different types of MT with varying surgical scopes. CONCLUSIONS: This study is the first to investigate the effect of various surgery scope on drug delivery by transnasal nebulization to...