Computational Modeling of Nasal Drug Delivery Using Different Intranasal Corticosteroid Sprays for the Treatment of Eustachian Tube Dysfunction.

Elias Sundström, Rehab Talat, Ahmad R Sedaghat, Sid Khosla, Liran Oren
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引用次数: 1

Abstract

Eustachian tube dysfunction (ETD) is a common otolaryngologic condition associated with decreased quality of life. The first-line treatment of ETD is intranasal corticosteroid sprays (INCS). Computational fluid dynamics (CFD) was used to study particle deposition on the Eustachian tube (ET) using two commercial INCS (Flonase and Sensimist). Simulations also considered the effects of nostril side, insertion depth, insertion angle, cone spray angle, inhaling rates, wall impingement treatment, and fluid film. Flonase and Sensimist produced different particle size distributions and sizes. Sensimist droplets are smaller, less sensitive to asymmetry in nostrils anatomy and variation in insertion angle, and therefore can reach the posterior nasopharynx more readily. Flonase produces larger particles with greater inertia. Its particles deposition is more sensitive to intrasubject variation in nasal anatomy and insertion angles. The particle deposition on the ET was sensitive to the wall impingement model. The deposition on the ET was insignificant with adherence only <0.15% but increased up to 1-4% when including additional outcomes rebound and splash effects when droplets impact with the wall. The dose redistribution with the fluid film is significant but plays a secondary effect on the ET deposition. Flonase aligned parallel with the hard palate produced 4% deposition efficiency on the ET, but this decreased <0.14% at the higher insertion angle. INCS with larger droplet sizes with a small insertion angle may be more effective at targeting droplet deposition on the ET opening.

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不同鼻内皮质类固醇喷雾剂治疗咽鼓管功能障碍的鼻腔给药计算模型。
耳咽管功能障碍(ETD)是一种常见的耳鼻喉疾病,与生活质量下降有关。ETD的一线治疗是鼻内皮质类固醇喷雾剂(INCS)。利用Flonase和Sensimist两种商用INCS,采用计算流体力学(CFD)研究了颗粒在耳咽管(ET)上的沉积。模拟还考虑了鼻孔侧面、插入深度、插入角度、锥形喷射角度、吸入速率、壁面撞击处理和流体膜的影响。Flonase和Sensimist产生不同的粒度分布和大小。敏感液滴体积小,对鼻孔解剖的不对称性和插入角度的变化不太敏感,因此更容易到达鼻咽后端。氟化酶产生的颗粒更大,惯性更大。其颗粒沉积对主体内鼻腔解剖结构和插入角度的变化更为敏感。颗粒沉积对壁面撞击模型较为敏感。ET上的沉积不显著,仅粘附
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