A. Tsikoudas et Jj. Homer, The delivery of topical nasal sprays and drops to the middle meatus: a semiquantitative analysis, CLIN OTOLAR, 26(4), 2001, pp. 294-297
The distribution of nasal drugs specifically to the middle meatus is of vit
al importance in the treatment of rhinosinusitis and nasal polyposis. It is
widely assumed that the intranasal distribution is superior with nasal dro
ps rather than spray delivery. However, a comparison of nasal spray and dro
p delivery specifically to this area has not been studied before. This stud
y aims to compare semiquantitatively the intranasal distribution of nasal s
prays and drops to the middle meatus in vivo. A novel method was used where
by a neurosurgical patty was placed in the middle meatus. Topical nasal dro
ps and aqueous sprays dyed with methylene blue (0.1% v/v) were administered
in a standardized fashion in normal volunteers. The subsequent absorption
of administered dye was classified on a four-point scale. A randomized pros
pective cross-over design was used for the study. We found that there was n
o difference in the delivery of nasal drug to the middle meatus between eit
her method of drug administration (P>0.2). The perceived superiority of nas
al drops may therefore be as a result of the acknowledged systemic effect o
f betamethasone drops.