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Intranasal delivery of drugs to eustachian tube orifice

Published online by Cambridge University Press:  12 July 2011

Y G Karagama ,
M Rashid ,
J L Lancaster ,
A Karkanevatos  and
R S William
Y G Karagama
Affiliation:
Department of Otolaryngology, Tameside Hospital, Ashton-under-Lyne, UK
M Rashid*
Affiliation:
Department of Otolaryngology, Tameside Hospital, Ashton-under-Lyne, UK
J L Lancaster
Affiliation:
Department of Otolaryngology, Tameside Hospital, Ashton-under-Lyne, UK
A Karkanevatos
Affiliation:
Department of Otolaryngology, Tameside Hospital, Ashton-under-Lyne, UK
R S William
Affiliation:
Department of Otolaryngology, Tameside Hospital, Ashton-under-Lyne, UK
*
Address for correspondence: Mr Mamun Rashid, ENT Department, Ward 29, Charlesworth Building, Tameside Hospital, Ashton-under-Lyne OL6 9RW, UK Fax: +44 (0)161 331 6457 E-mail: [email protected]
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Abstract

Background:

Intranasal medication administration which aims to deliver to the eustachian tube orifice has been adopted for the management of a number of otological conditions, acting via a reduction in tubal oedema and improved ventilation. Evidence for the optimal head position for such drug administration is limited. We compared four different positions and also assessed spray versus drop formulation, to determine optimal delivery conditions.

Methods:

Prospective, five-period, cross-over study using methylene blue dyed saline in a drops or spray container. Five healthy volunteers tested the Mygind, Ragan, Mecca and ‘head back’ head positions. Nasal spray drug delivery in the most effective head position was then compared with drops drug delivery (administered in the head back position). Intranasal delivery was assessed photographically using a 30° rigid naso-endoscope.

Results:

Maximal nasal drops delivery was achieved with the Mygind and Ragan positions. Drops were more successful than spray in reaching the eustachian tube orifice.

Conclusion:

The Mygind and Ragan positions are best for eustachian tube orifice drug delivery, and drops preparations are better than spray preparations.

Keywords

Administration, IntranasalEustachian TubeTherapeuticsNasopharynxEndoscopy
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 125 , Issue 9 , September 2011 , pp. 934 - 939
Copyright
Copyright © JLO (1984) Limited 2011

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References

1Fireman, P. Otitismedia and eustachian tube dysfunction:connection to allergic rhinitis. J Allergy Clin Immunol 1997;99(suppl):S787–97CrossRefGoogle Scholar
2Lildholdt, T, Cantekin, EI, Bluestone, CD, Rockette, HE. Effect of a topical nasal decongestant on Eustachian tube function in children with tympanotomytubes. Acta Otolaryngol 1982;94:93–7CrossRefGoogle Scholar
3Tracy, JM, Dermain, JG, Hoffman, KM, Goetz, DW. Intranasal beclomethasone as an adjunct to the treatment of chronic middle ear effusion. Ann Allergy 1998;80:198–206CrossRefGoogle Scholar
4Venkatayan, N, Troublefield, YL, Connelly, PE, Mautone, AJ, Chandrasekhar, SS. Intranasal surfactant aerosol therapy for otitis media with effusion. Laryngoscope 2000;110:1857–60CrossRefGoogle ScholarPubMed
5Elies, W. Topical steroids in the treatment of mucosal swelling of the nasal cavity. Chemotherapie Journal 1997;6(suppl):31–4Google Scholar
6Shapiro, G, Bierman, C, Furukawa, C, Pierson, W, Berman, R, Donaldson, J et al. Treatment of persistent eustachian tube dysfunction in children with aerosolized nasal dexamethasone phosphate versus placebo. Ann Allergy 1982;49:81–5Google ScholarPubMed
7Danner, C.Middle earatelectasis: what causes it and how is it corrected? Otolaryngol Clin North Am 2006;39:1211–19CrossRefGoogle Scholar
8Karagama, YG, Lancaster, JL, Karkanevatos, A, O'Sullivan, G. Delivery of nasal drops to the middle meatus: which is the best head position? Rhinology 2001;39:226–9Google Scholar
9Friedman, RA, Doyle, WJ, Casselbrant, ML, Bluestone, C, Fireman, P. Immunological-mediated eustachian tube obstruction: a double-blind crossover study. J Allergy Clin Immunol 1993;71:442–7CrossRefGoogle Scholar
10Skoner, DP, Doyle, WJ, Boehm, S, Fireman, P. Effect of terfernadine on nasal, eustachian tube and pulmonary function after provocative intranasal histamine challenge. Ann Allergy 1991;67:619–24Google ScholarPubMed
11Skoner, DP, Lee, L, Doyle, WJ, Boehm, S, Fireman, P. Nasal physiology and inflammatory response mediators during natural pollen exposure. Ann Allergy 1990;65:206–10Google Scholar
12Bernstein, JM. Role of allergy in eustachian tube blockage and otitis with effusion: a review. Otolaryngol Head Neck Surg 1996;114:562–7CrossRefGoogle ScholarPubMed
13Mattucci, KF, Barak, G. Middle ear effusion – allergy relationships. Ear Nose Throat J 1995;74:752–8CrossRefGoogle ScholarPubMed
14Stenstrom, C, Bylander-Groth, A, Ingvarsson, L. Eustachian tube function in otitis prone and healthy children. Int J Pediatr Otorhinolaryngol 1991;21:127–38CrossRefGoogle ScholarPubMed
15Kraemer, MJ, Marshall, SG, Richardson, MA. Etiologic factors in the development of chronic middle ear effusions. Clin Rev Allergy 1984;2:319–28Google ScholarPubMed
16Moran, DM, Mutchie, KD, Higbee, MD, Paul, D. The use of antihistamine-decongestant in conjunction with an anti-infective drug in the treatment of acute otitis media. J Pediatr 1982;101:132–6CrossRefGoogle ScholarPubMed
17Stammberger, H, Posawetz, W. Functional endoscopic sinus surgery. Concept, indications and results of the Messerklinger technique. Eur Arch Otorhinolaryngol 1990;247:63–76CrossRefGoogle ScholarPubMed