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A computational study of functional endoscopic sinus surgery and maxillary sinus drug delivery.

Publication ,  Journal Article
Wofford, MR; Kimbell, JS; Frank-Ito, DO; Dhandha, V; McKinney, KA; Fleischman, GM; Ebert, CS; Zanation, AM; Senior, BA
Published in: Rhinology
March 2015

BACKGROUND: Topical medication is increasingly used following functional endoscopic sinus surgery (FESS). Information on particle sizes that maximise maxillary sinus (MS) delivery is conflicting, and the effect of antrostomy size on delivery is unclear. The purpose of this study was to estimate antrostomy and particle size effects on topical MS drug delivery. METHODOLOGY: Sinonasal reconstructions were created from a pre- and a post-FESS CT scan in each of four chronic rhinosinusitis patients. Additional models were created from each post-FESS reconstruction representing four alternative antrostomy sizes. Airflow and particle deposition were simulated in each reconstruction using computational fluid dynamics for nebulised and sprayed delivery. RESULTS: MS ventilation and drug delivery increased following FESS, the largest virtual antrostomy led to greatest delivery, and MS delivery was sensitive to particle size. Particles within a 5-18 μm and 5-20 μm size range led to peak MS deposition for nebulised and sprayed particles, respectively. Post-FESS increases in drug delivery varied across individuals and within individuals by the type of antrostomy created. CONCLUSION: Our findings suggest that FESS, particularly with larger antrostomies, improves topical drug delivery, and that certain particle sizes improve this delivery. Further research is needed to contextualise these findings with other post-surgical effects.

Duke Scholars

Published In

Rhinology

DOI

ISSN

0300-0729

Publication Date

March 2015

Volume

53

Issue

1

Start / End Page

41 / 48

Location

Netherlands

Related Subject Headings

  • Tomography, X-Ray Computed
  • Sinusitis
  • Rhinitis
  • Prospective Studies
  • Particle Size
  • Otorhinolaryngology
  • Nebulizers and Vaporizers
  • Maxillary Sinus
  • Imaging, Three-Dimensional
  • Hydrodynamics
 

Citation

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MLA
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Wofford, M. R., Kimbell, J. S., Frank-Ito, D. O., Dhandha, V., McKinney, K. A., Fleischman, G. M., … Senior, B. A. (2015). A computational study of functional endoscopic sinus surgery and maxillary sinus drug delivery. Rhinology, 53(1), 41–48. https://doi.org/10.4193/Rhino13.065
Wofford, M. R., J. S. Kimbell, D. O. Frank-Ito, V. Dhandha, K. A. McKinney, G. M. Fleischman, C. S. Ebert, A. M. Zanation, and B. A. Senior. “A computational study of functional endoscopic sinus surgery and maxillary sinus drug delivery.Rhinology 53, no. 1 (March 2015): 41–48. https://doi.org/10.4193/Rhino13.065.
Wofford MR, Kimbell JS, Frank-Ito DO, Dhandha V, McKinney KA, Fleischman GM, et al. A computational study of functional endoscopic sinus surgery and maxillary sinus drug delivery. Rhinology. 2015 Mar;53(1):41–8.
Wofford, M. R., et al. “A computational study of functional endoscopic sinus surgery and maxillary sinus drug delivery.Rhinology, vol. 53, no. 1, Mar. 2015, pp. 41–48. Pubmed, doi:10.4193/Rhino13.065.
Wofford MR, Kimbell JS, Frank-Ito DO, Dhandha V, McKinney KA, Fleischman GM, Ebert CS, Zanation AM, Senior BA. A computational study of functional endoscopic sinus surgery and maxillary sinus drug delivery. Rhinology. 2015 Mar;53(1):41–48.

Published In

Rhinology

DOI

ISSN

0300-0729

Publication Date

March 2015

Volume

53

Issue

1

Start / End Page

41 / 48

Location

Netherlands

Related Subject Headings

  • Tomography, X-Ray Computed
  • Sinusitis
  • Rhinitis
  • Prospective Studies
  • Particle Size
  • Otorhinolaryngology
  • Nebulizers and Vaporizers
  • Maxillary Sinus
  • Imaging, Three-Dimensional
  • Hydrodynamics