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Irrigation penetration of nasal delivery systems: A cadaver study
Author(s) -
Abadie Wesley M.,
McMains Kevin C.,
Weitzel Erik Kent
Publication year - 2010
Publication title -
international forum of allergy and rhinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.503
H-Index - 46
eISSN - 2042-6984
pISSN - 2042-6976
DOI - 10.1002/alr.20002
Subject(s) - medicine , cadaver , nasal cavity , penetration (warfare) , cadaveric spasm , delivery system , irrigation , maxillary sinus , drill , surgery , biomedical engineering , dentistry , mechanical engineering , agronomy , engineering , operations research , biology
Background To determine the sinus penetration potential of several commercially available irrigation systems in maximally operated sinus cavities; cadaveric study in a tertiary care center. Methods Seven fresh cadaver heads with brains removed were maximally dissected to include a Draf III frontal sinusotomy, wide maxillary antrostomy, and complete sphenoethmoidectomy. Drill‐holes (4 mm) were created to allow visualization of the irrigations from within the respective sinus cavity. Seven commercially available irrigation systems were then tested according to manufacturer recommendation, and the data recorded using an ordinal scale for comparison. Results Among the 3 atomized particle delivery systems tested, the squeeze atomizer took 1.15 attempts, the pump atomizer took 1.85 attempts, and the mechanized atomizer required 30 seconds of continuous application for intrasinus delivery of aerosol ( p = 0.009). Penetration with 4 heavy irrigators showed significant variability depending on the sinus cavity being tested. The NeilMed irrigator showed more consistent penetration than any other tested device ( p < 0.01). The other systems tested had varying degrees of efficacy, dependent on sinus cavity irrigated. Conclusion Delivery of irrigant to maximally operated sinus cavities is variable and highly dependent on the method of nasal delivery. Use of these systems should be tailored appropriately for the desired effect. © 2011 ARS‐AAOA, LLC.