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European Annals of Otorhinolaryngology, Head and Neck Diseases
Sous presse. Epreuves corrigées par l'auteur. Disponible en ligne depuis le vendredi 24 août 2012
Doi : 10.1016/j.anorl.2011.09.002
Sonic aerosol therapy to target maxillary sinuses
 

M. Durand a, b, c, d, ⁎ , S. Le Guellec e, f, J. Pourchez c, g, F. Dubois b, c, h, G. Aubert i, G. Chantrel j, L. Vecellio e, f, C. Hupin k, R. De Gersem l, G. Reychler m, L. Pitance m, P. Diot f, F. Jamar l
a Service d’ORL et chirurgie cervico-faciale, centre hospitalier Émile-Roux, 43012 Le Puy-en-Velay, France 
b IFR Inserm 143, faculté de médecine, université Jean-Monnet, 42023 Saint-Étienne, France 
c LINA, EA 4624, 42023 Saint-Étienne, France 
d Université de Lyon, 42023 Saint-Étienne, France 
e DTF-Aerodrug, faculté de médecine, bâtiment M, 10 ter, boulevard Tonnellé, 37032 Tours, cedex, France 
f Inserm U-618, protéases et vectorisation pulmonaires, faculté de médecine, université François-Rabelais, 37032 Tours, France 
g IFR Inserm 143, École nationale supérieure des mines de Saint-Étienne, centre ingénierie et santé, 42023 Saint-Étienne, France 
h Service de médecine nucléaire, CHU de Saint-Étienne, 42055 Saint-Étienne, France 
i Laboratoire de bactériologie, CHU de Saint-Étienne, 42055 Saint-Étienne, France 
j DTF-Médical, 19, rue de la Presse, BP 132, 42003 Saint-Étienne, France 
k Service d’otorhinolaryngologie, cliniques universitaires Saint-Luc, université catholique de Louvain, avenue Hippocrate, 10, 1200 Bruxelles, Belgium 
l Service de médecine nucléaire, cliniques universitaires Saint-Luc, université catholique de Louvain, avenue Hippocrate, 10, 1200 Bruxelles, Belgium 
m Service de pneumologie, cliniques universitaires Saint-Luc, université catholique de Louvain, avenue Hippocrate, 10, 1200 Bruxelles, Belgium 

Corresponding author.
Summary
Aim

Intranasal aerosol administration of drugs is widely used by ENT specialists. Although clinical evidence is still lacking, intranasal nebulization appears to be an interesting therapeutic option for local drug delivery, targeting anatomic sites beyond the nasal valve. The sonic nebulizer NL11SN associates a 100Hertz (Hz) sound to the aerosolization to improve deposition in the nasal/paranasal sinuses. The aim of the present study was: to evaluate in vivo the influence of associating a 100Hz sound on sinus ventilation and nasal and pulmonary aerosol deposition in normal volunteers, and; to quantify in vitro aerosol deposition in the maxillary sinuses in a plastinated head model.

Material and methods

Scintigraphic analysis of 81mKr gas ventilation and of sonic aerosol (99mTc-DTPA) deposition using the NL11SN was performed in vivo in seven healthy volunteers. In parallel, NL11SN gentamicin nebulization was performed, with or without associated 100Hz sound, in a plastinated human head model; the gross amount of gentamicin delivered to the paranasal sinuses was determined by fluorescence polarization immunoassay.

Results

Associating the 100Hz sound to 81mKr gas ensured paranasal sinus ventilation in healthy volunteers. 99mTc-DTPA particles nebulized with the NL11SN were deposited predominantly in the nasal cavities (2/3, vs 1/3 in the lungs). In vitro, the use of NL11SN in sonic mode increased gentamicin deposition threefold in the plastinated model sinuses (P <0.002); the resulting antibiotic deposit would be sufficient to induce a local therapeutic effect.

Conclusion

The NL11SN nebulizer ensured preferential nasal cavity aerosol deposition and successfully targeted the maxillary sinuses.


Keywords : Sonic aerosol, 100Hertz, Scintigraphy, Healthy volunteers, Plastinated head model, Nasal, Sinus, Rhinosinusitis


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Introduction
Material and methods  (+)
Results
Discussion
Conclusions
Disclosure of interest


© 2011  Published by Elsevier Masson SAS.
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