Djupesland PG, Skretting A, Windern M, Holand T.
Laryngoscope. 116(3): 466-472.
Abstract
Objectives
The objective was to compare nasal deposition patterns achieved with a conventional hand actuated spray pump and a novel breath actuated bi-directional prototype device housing the same spray pump (OptiMist™, OptiNose AS, Oslo, Norway).
Study Design and Methods
The bi-directional delivery device exploits the posterior connection between the nasal passages persisting when the velum automatically closes during oral exhalation. The deposition and clearance patterns achieved with the two devices were compared in nine healthy subjects by scintigraphy after administration of 99mTc-aerosols.
Results
Compared with traditional spray pump delivery, the OptiMist device provided significantly (P < .004) larger initial and cumulative deposition (area under the deposition vs. time curve) in the upper posterior segment of the nasal passage, housing the sinus ostia and the olfactory region, and significantly lower deposition (P < .004) in the anterior segment, lined by nonciliated squamous epithelium. Furthermore, intersubject reproducibility of the initial and cumulative deposition was higher for the OptiMist™ device both in the upper posterior segment and the entire nose.
Conclusions
Compared with a spray pump, the novel breath actuated bi-directional device provides significantly larger deposition in the clinically important regions beyond the nasal valve and reduced anterior deposition. These striking differences provide new opportunities for improved therapy of chronic rhinosinusitis and polyposis as well as extended use of the nose for delivery of drugs from the nose into the brain.