Institute for Lung Biology and Disease, Helmholtz Zentrum München - German Research Center for Environmental Health, Ingolstädter Landstrasse 1, Neuherberg, Germany.
Expert Opin Drug Deliv. 2010 Nov;7(11):1239-45. doi: 10.1517/17425247.2010.523078. Epub 2010 Sep 27.
There is a high incidence of nasal disorders including chronic rhinosinusitis (CRS), affecting ∼ 14% of the total population. However, a topical treatment regimen shows only modest efficacy, and drug delivery to the posterior nose, osteomeatal area, and paranasal sinuses is still a challenge. Therefore, the primary treatment option of CRS is functional endonasal sinus surgery (FESS). Most nasally administered aerosolized drugs are efficiently filtered by the nasal valve and do not reach the sinuses, the site of chronic inflammation. Sinus ventilation, nasal and paranasal aerosol deposition can be achieved by using a pulsating airflow, offering new topical treatment options for nasal disorders. Inhalation studies in nasal casts and in healthy volunteers have shown up to 8% of the nasally deposited drug within the sinuses, which could not be achieved using nasal pump sprays. In addition, compared with nasal pump sprays, retention kinetics of the radiolabel deposit in the nose was prolonged by about a factor of five. With this efficiency, topical aerosol therapies of sinus disorders can be achieved and, owing to the prolonged retention, reduced application modes are possible. This offers new treatment options of sinus-nasal disorders in comparison with or after FESS.
鼻腔疾病的发病率很高，包括慢性鼻-鼻窦炎（CRS），影响了约 14%的总人口。然而，局部治疗方案的疗效仅为中等，药物向鼻腔后部、筛窦口和鼻旁窦的递送仍然是一个挑战。因此，CRS 的主要治疗选择是功能性鼻内镜鼻窦手术（FESS）。大多数经鼻给予的雾化药物都被鼻阀有效地过滤，无法到达鼻窦这一慢性炎症部位。通过脉动气流可以实现鼻窦通气和鼻及鼻旁窦的气溶胶沉积，为鼻腔疾病提供了新的局部治疗选择。在鼻腔铸型和健康志愿者中的吸入研究表明，在鼻窦中可达到 8%的鼻腔沉积药物，这是使用鼻泵喷雾无法实现的。此外，与鼻泵喷雾相比，放射性标记物在鼻腔中的保留动力学延长了约五倍。通过这种效率，可以实现鼻窦疾病的局部气溶胶治疗，并且由于保留时间延长，可以减少应用模式。与 FESS 相比或之后，这为鼻窦-鼻腔疾病提供了新的治疗选择。
