Particle deposition of therapeutic aerosols in the nose and paranasal sinuses after transnasal sinus surgery: a cast model study.

BACKGROUND: The topical administration of steroids or antibiotics to the nose and the sinuses is one of the important postsurgical therapies of endoscopic sinus surgery (ESS).

METHODS: To investigate the effective deposition of aerosols in the paranasal sinuses after ESS, we restored the human nasosinus model that underwent ESS and studied the particle depositions on the ostiomeatal complex (OMC), maxillary, and ethmoid sinuses quantitatively.

RESULTS: A 45 degree nozzle insertion angle significantly increased the particle depositions more than the 30 degree angle (p < 0.05). A computer simulation-assisted analysis shows that the inertial deposition at OMC increased with a nozzle angle of 45 degrees versus 30 degrees. The particles with 5.63 microm in diameter significantly deposit on OMC and maxillary sinus compared with the particles with 16.37 microm (p < 0.05).

CONCLUSION: The topical administration of drugs to the paranasal sinuses postoperatively must be performed in consideration with aerodynamics of aerosols.