Institute for Lung Biology and Disease (iLBD), Helmholtz Zentrum München, Neuherberg, Germany.
PLoS One. 2013 Sep 11;8(9):e74991. doi: 10.1371/journal.pone.0074991. eCollection 2013.
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.
(99m)Tc-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.
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). Accordingly, maxillary and sphenoidal sinus deposition was 4.8+/-2.2% and 8.2+/-3.8% of the nasal dose (p<0.01). Neither in healthy volunteers nor in CRS patients there was significant dose in the frontal sinuses.
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.
慢性鼻-鼻窦炎（CRS）是一种常见的上呼吸道慢性疾病，对生活质量有很大影响。将药物递送到鼻窦是具有挑战性的，因此手术率很高。本研究调查了脉冲气溶胶相对于鼻泵喷雾剂在健康志愿者和鼻窦手术后的 CRS 患者中的鼻窦和鼻腔的递药效率。
在没有鼻息肉的 11 例 CRSsNP 患者中，在鼻窦手术后之前和之后应用（99m）Tc-DTPA 脉冲气溶胶。此外，还将脉冲气溶胶与鼻泵喷雾剂进行了比较，研究了 11 例健康志愿者。通过前位和侧位平面伽马相机成像评估总鼻和额窦、上颌窦和蝶窦气溶胶沉积和肺穿透。
在健康志愿者中，鼻泵喷雾剂导致 100%的鼻腔、非显著鼻窦和肺沉积，而脉冲气溶胶导致 61.3+/-8.6%的鼻腔沉积和 38.7%从另一个鼻孔排出。9.7+/-2.0%的鼻腔剂量穿透到上颌窦和蝶窦。在 CRS 患者中，总鼻腔沉积分别为鼻窦手术后之前和之后的 56.7+/-13.3%和 46.7+/-12.7%（p<0.01）。相应地，上颌窦和蝶窦沉积分别为鼻腔剂量的 4.8+/-2.2%和 8.2+/-3.8%（p<0.01）。无论是在健康志愿者还是 CRS 患者中，额窦都没有明显的剂量。
与鼻泵喷雾剂相比，脉冲气溶胶可以将大量剂量递送到后鼻腔和副鼻窦，为鼻窦手术后提供替代治疗选择。基于清除功能障碍的慢性肺部疾病患者也可能受益于脉冲气溶胶，因为这些疾病也在上呼吸道表现出来。
