Frank-Ito Dennis Onyeka
Department of Head and Neck Surgery & Communication Sciences, Duke University Medical Center, Durham, North Carolina, USA.
Department of Mechanical Engineering and Materials Science, Duke University, Durham, North Carolina, USA.
Expert Opin Drug Deliv. 2025 Apr;22(4):511-524. doi: 10.1080/17425247.2025.2467784. Epub 2025 Feb 27.
Olfactory function, despite its critical role in human survival and quality of life, is often underappreciated. This could be associated with the fact that symptoms of olfactory dysfunction rarely occur in isolation as they are frequently concomitant with comorbidities. Furthermore, effective treatments for olfactory dysfunction largely remain elusive, and no standardized clinical practice for treating this dysfunction currently exist, thus complicating the initiation of appropriate therapeutic modalities. Intranasal administration of topical medication targeting the olfactory cleft represents a safe, noninvasive and potentially efficacious approach, but several challenges impede effective drug delivery.
This review highlights the importance of human olfaction, assessment of olfactory function, underlying sources of olfactory dysfunction, and challenges involved in developing long-term and effective treatment modalities, particularly in the administration of topical medication to the olfactory cleft intranasally. Advancements in both device-related and administration-related modalities designed to enhance intranasal drug delivery are discussed.
Clinical management typically prioritizes comorbid conditions, relegating symptoms pertaining olfactory dysfunction to ancillary concerns. Device manufacturers for intranasal administration likewise underestimate the complexity and variabilities of the nasal cavity, and how these impact drug transport. Synergistic implementation of device and formulation strategies can potentially yield enhanced olfactory cleft drug delivery.
嗅觉功能尽管在人类生存和生活质量中起着关键作用,但常常未得到充分重视。这可能与嗅觉功能障碍症状很少单独出现这一事实有关,因为它们经常与合并症同时存在。此外,嗅觉功能障碍的有效治疗方法在很大程度上仍然难以捉摸,目前尚无治疗这种功能障碍的标准化临床实践,因此使得启动适当的治疗方式变得复杂。经鼻给予靶向嗅裂的局部用药是一种安全、无创且可能有效的方法,但有几个挑战阻碍了有效的药物递送。
本综述强调了人类嗅觉的重要性、嗅觉功能的评估、嗅觉功能障碍的潜在根源以及开发长期有效治疗方式所涉及的挑战,特别是经鼻向嗅裂给予局部用药方面。讨论了旨在增强经鼻药物递送的与器械相关和与给药相关方式的进展。
临床管理通常优先考虑合并症,将与嗅觉功能障碍相关的症状降为次要关注点。用于经鼻给药的器械制造商同样低估了鼻腔的复杂性和变异性,以及这些因素如何影响药物转运。器械和制剂策略的协同实施可能会提高嗅裂的药物递送效果。