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Does endoscopic balloon dilatation improve intranasal drug delivery to the olfactory cleft? A pre-clinical cadaver feasibility study

Published online by Cambridge University Press:  14 February 2022

D Gershnabel Milk Open the ORCID record for D Gershnabel Milk [Opens in a new window] ,
G C Khong ,
O H Çam ,
A Fernando ,
C Tierney ,
F Kassem  and
S C Leong Open the ORCID record for S C Leong [Opens in a new window]
D Gershnabel Milk
Affiliation:
Liverpool Head and Neck Centre, Liverpool University Hospitals NHS Foundation Trust, UK Department of Otolaryngology – Head and Neck Surgery, Meir Medical Center, Kfar Saba, Israel, and Sackler Faculty of Medicine, Tel Aviv University, Israel
G C Khong
Affiliation:
Liverpool Head and Neck Centre, Liverpool University Hospitals NHS Foundation Trust, UK
O H Çam
Affiliation:
Liverpool Head and Neck Centre, Liverpool University Hospitals NHS Foundation Trust, UK Faculty of Medicine, Başkent University, Ankara, Turkey
A Fernando
Affiliation:
Liverpool Head and Neck Centre, Liverpool University Hospitals NHS Foundation Trust, UK Department of Otolaryngology, Hospital Central Militar, Mexico City, Mexico
C Tierney
Affiliation:
Human Anatomy Resource Centre, University of Liverpool, UK
F Kassem
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Meir Medical Center, Kfar Saba, Israel, and Sackler Faculty of Medicine, Tel Aviv University, Israel
S C Leong*
Affiliation:
Liverpool Head and Neck Centre, Liverpool University Hospitals NHS Foundation Trust, UK
*
Author for correspondence: Mr Samuel C Leong, Liverpool Head and Neck Centre, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK E-mail: Lcheel@doctors.org.uk
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Abstract

Background

Although systemic steroids have been shown to improve olfactory function, topical steroids have not demonstrated the same efficacy. This could a result of limited drug delivery to the narrow, superiorly placed olfactory cleft. This study aimed to examine the penetration of intranasal drugs to the olfactory cleft following endonasal balloon dilatation.

Methods

Balloon dilatation was performed in 12 thawed, fresh-frozen cadaver specimens. In the Mygind position, nasal drops mixed with blue food dye were administered into the nostril before and after the dilatation procedure. Endoscopic videos were recorded to assess dye staining of the olfactory cleft and osteo-meatal complex using a 4-point Likert scale.

Results

Prior to balloon dilatation, the mean penetration of nasal drops into the olfactory cleft was 1.34, which improved significantly (p < 0.05) to 2.66 following the procedure. There was no change in dye penetration into the osteo-meatal complex after balloon dilatation.

Conclusion

The results of this exploratory study suggest that balloon dilatation may improve the delivery of nasal drops to the olfactory cleft area. The clinical applicability and impact on olfactory function will require further assessment.

Keywords

Paranasal SinusesDilatationSmell
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 136 , Issue 10 , October 2022 , pp. 970 - 974
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Mr S Leong takes responsibility for the integrity of the content of the paper

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