Leclerc Lara, Prévôt Nathalie, Hodin Sophie, Delavenne Xavier, Mentzel Heribert, Schuschnig Uwe, Pourchez Jérémie
Mines Saint-Etienne, Université Jean Monnet Saint-Etienne, INSERM, Sainbiose U1059, Centre CIS, F-42023 Saint-Etienne, France.
Université Jean Monnet Saint-Étienne, Mines Saint-Etienne, INSERM, Sainbiose U1059, F-42023 Saint-Etienne, France.
Pharmaceuticals (Basel). 2023 Jan 17;16(2):135. doi: 10.3390/ph16020135.
This study aims to evaluate the impact of the nasal delivery technique and nebulizing technologies (using different frequencies of oscillating airflow) for acoustic aerosol targeting of maxillary sinuses. Sodium fluoride (chemical used as a marker), tobramycin (drug used as a marker) and Tc-DTPA (radiolabel aerosol) were used to assess the intrasinus aerosol deposition on a nasal cast. Two commercial medical devices (PARI SINUS nebulizer and NL11SN ATOMISOR nebulizer) and various nasal delivery techniques (one or two nostrils connected to the aerosol inlet, the patient with the soft palate closed or open during the acoustic administration of the drug, the presence or not of flow resistance in the nostril opposite to the one allowing the aerosol to be administered) were evaluated. The closed soft palate condition showed a significant increase in drug deposition even though no significant difference in the rest of the nasal fossae was noticed. Our results clearly demonstrated a higher intrasinus aerosol deposition (by a factor 2-3; respectively 0.03 ± 0.007% vs. 0.003 ± 0.0002% in the right maxillary sinus and 0.027 ± 0.006% vs. 0.013 ± 0.004% in the left maxillary sinus) using the acoustic airflow generated by the PARI SINUS compared to the NL11SN ATOMISOR. The results clearly demonstrated that the optimal conditions for aerosol deposition in the maxillary sinuses were obtained with a closed soft palate. Thus, the choice of the nebulizing technology (and mainly the frequency of the pulsating aerosol generated) and also the recommendation of the best nasal delivery technique are key factors to improve intrasinus aerosol deposition.
本研究旨在评估鼻腔给药技术和雾化技术(使用不同频率的振荡气流)对上颌窦声学气溶胶靶向的影响。使用氟化钠(用作标记物的化学物质)、妥布霉素(用作标记物的药物)和锝-二乙三胺五乙酸(放射性标记气溶胶)来评估鼻腔模型上鼻窦内的气溶胶沉积情况。评估了两种商用医疗设备(PARI SINUS雾化器和NL11SN ATOMISOR雾化器)以及各种鼻腔给药技术(一个或两个鼻孔连接到气溶胶入口、在药物声学给药期间软腭闭合或张开的患者、与允许气溶胶给药的鼻孔相对的鼻孔中是否存在气流阻力)。即使在其余鼻道中未发现显著差异,但软腭闭合状态下药物沉积显著增加。我们的结果清楚地表明,与NL11SN ATOMISOR相比,使用PARI SINUS产生的声学气流时,鼻窦内的气溶胶沉积更高(分别为2至3倍;右上颌窦中分别为0.03±0.007%对0.003±0.0002%,左上颌窦中为0.027±0.006%对0.013±0.004%)。结果清楚地表明,软腭闭合可获得上颌窦内气溶胶沉积的最佳条件。因此,雾化技术的选择(主要是所产生脉动气溶胶的频率)以及最佳鼻腔给药技术的推荐是改善鼻窦内气溶胶沉积的关键因素。