Sara Vahaji1, Yidan Shang2, Yu Zhang2, Eugene Wong3,4, Amgad Rezk5, Leslie Yeo5, Sarah Vreugde6, Peter-John Wormald6, Narinder Singh4, Kiao Inthavong This email address is being protected from spambots. You need JavaScript enabled to view it.2 

1 School of Engineering, Deakin University,Geelong, Victoria 3217, Australia
2 Mechanical and Automotive Engineering, School of Engineering, RMIT University, Bundoora, Victoria 3083, Australia
3 Department of Otolaryngology, Head and Neck Surgery, Westmead Hospital, Sydney, Australia
4 Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead Hospital, Sydney, NSW, Australia
5 Chemical Engineering, School of Engineering, RMIT University, Melbourne, Victoria 3000, Australia
6 Department of Otolaryngology, Head and Neck Surgery, Adelaide Medical School, Australia


Received: April 25, 2021
Revised: July 16, 2021
Accepted: September 11, 2021

 Copyright The Author(s). This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are cited.


Download Citation: ||https://doi.org/10.4209/aaqr.210098  


Cite this article:

Vahaji, S., Shang, Y., Zhang, Y., Wong, E., Rezk, A., Yeo, L., Vreugde, S., Wormald, P.J., Singh, N., Inthavong, K. (2021). Optimising Aerosol Delivery for Maxillary Sinus Deposition in a Post-FESS Sinonasal Cavities. Aerosol Air Qual. Res. https://doi.org/10.4209/aaqr.210098


HIGHLIGHTS 

  • Aerosol deposition in maxillary sinus was investigated.
  • Experimental measurements of the pressure distribution throughout the nasal cavity.
  • Measured flow resistance from ambient pressure to the posterior nasal cavity.
  • Our transient scale-resolving CFD simulation captured turbulent flow features.
  • Anterior half displayed laminar-like behavior while the posterior half was turbulent.
 

ABSTRACT


Optimal management of chronic rhinosinusitis (CRS) endotypes includes post-operative application of topical formulations. There is little evidence regarding the ideal aerosol delivery characteristics and techniques to achieve the most efficient deposition on affected sinus mucosa. Nebulisers provide an alternative to nasal sprays by producing smaller particle sizes at lower velocities. We applied a reverse-particle-tracking simulation using computational fluid dynamics (CFD) to evaluate the ideal aerosol characteristics from a nebuliser to target the post-operative maxillary sinus mucosa. A CT scan of a CRS patient was used to create a pre-operative and virtual post-operative model. Particles of diameter 2 to 30 μm were tracked through the sinonasal cavity at 5,10 and 15 L min-1 flow rates using CFD. Reverse particle simulations demonstrated that the optimised combination of parameters were 20 μm particles, delivered at 5 m s-1 (or 14 microns, delivered at 15 m s-1) at an inhalation rate of 5 L min-1, released from a nozzle in an elliptical oblique-superior direction into the superior half of the nasal valve significantly improved the maximum deposition efficiency (from 3% up to 55%) in the post-operative maxillary sinus mucosa. The nebulised spray (without optimisation) demonstrated negligible particle deposition within the sinuses of the pre-op model, while it increased marginally in the post-op model for smaller diameter particles at lower inhalation rates. The ideal combination of parameters to achieve targeted medication deposition on specific sinus mucosal surfaces can guide the development of new nasal drug delivery devices that produce the desired deposition regions for clinical applications in post-operative CRS patients.


Keywords: Sinonasal cavity, Spray atomisation, Aerosol deposition, Inhaled aerosol, CFD




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