ABSTRACT
The aim of this paper is to review mechanisms and solutions for nasal drug delivery. Literature survey was performed via PubMed, Google Scholar, Google, and ProQuest Central database of Kirikkale University. The nasal lining presents a large area of endothelium of variable permeability and with a rich vascular supply. Advantages of this route include eliminating first-pass metabolism and being easily accessible. The nasal route enables some agents which are otherwise difficult to administer to enter the systemic circulation, for example, low molecular mass compounds with high polarity, peptides, or proteins. There are three principal factors that influence the extent to which drugs can be absorbed through the nasal lining, namely the physico-chemical characteristics of the drug molecule itself, the action of the mucociliary system within the nose, and the presence of any factors increasing nasal absorption. A key factor limiting the use of the intranasal route of administration is insufficient absorption through the nasal mucosa. A number of drugs in development cannot be administered intranasally because their bioavailability following nasal administration is too low. There has been considerable research focus on methods to enhance absorption via the nasal mucosa. In this chapter, we review the literature related to this problem and discuss potential solutions.
Subject(s)
Drug Delivery Systems , Nasal Mucosa , Humans , Administration, Intranasal , Nasal Mucosa/metabolism , Pharmaceutical Preparations , Biological AvailabilityABSTRACT
BACKGROUND: The objective of the study is evaluation of ciliary function and mucosal cytology after endoscopic sinus surgery in children with chronic rhinosinusitis (CRS). METHODOLOGY: A total of 132 children with CRS who underwent endoscopic sinus surgery, as well as 15 healthy controls were involved in the study. In this follow-up study patients were examined preoperatively, as well as 3, 6, 9, and 12 months after endoscopic sinus surgery. Assessment of ciliary function and sinonasal mucosal cytology was performed using high-speed videomicroscopy. Lund-Kennedy, Lund-Mackay, and sinonasal outcome test 20 (SNOT20) scores were also evaluated. RESULTS: Total SNOT-20, Lund-Mackay, and Lund-Kennedy values significantly decreased after sinus surgery. In contrast, ciliary function and mucosal cytology only tended to improve after 6 months. 9 months after surgery the number of ciliated cells, ciliary beat frequency, cell viability, and ciliary length were significantly higher than preoperatively. The most significant improvement of ciliary function and cell height was observed 12 months after operation, whereas epithelial dystrophy and neutrophil infiltration were significantly reduced. CONCLUSIONS: Substantial improvement was observed only in a year after surgery, whereas 0 to 3 months after the surgery ciliary function was severely impaired thus predisposing to recurrent sinusitis or other complications.
Subject(s)
Rhinitis , Sinusitis , Child , Chronic Disease , Endoscopy , Follow-Up Studies , Humans , Rhinitis/surgery , Sinusitis/surgery , Treatment OutcomeABSTRACT
PURPOSE: To describe the principles of medical navigation systems in head and neck surgery, the possibility of their application and the existing limitations. MATERIAL AND METHODS: The article presents the generalized experience of image-guidance equipment using in the ENT Department of First Pavlov State Medical University. 298 operations, mostly FESS, were performed from 2013 to 2018 under the control of navigation system. The majority of cases consisted of surgical treatment of chronic sinusitis, tumors of the nasal cavity and paranasal sinuses; also, navigation control was useful in the case of altered intranasal anatomy after previous surgical treatment or due to chronic polyposis. A case report of frontal sinus inverted papilloma surgical treatment, controlled by an electromagnetic navigation system, is presented. RESULTS: The use of navigation systems in head and neck surgery can improve surgery accuracy and safety, as well as providing a unique opportunity to learn FESS in real time.
