xRead - Olfactory Disorders (September 2023)

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589

PATEL et al.

TABLE IX.26 Systematic review on head position for topical medication to reach olfactory mucosa Author Year LOE Study design Study groups Clinical end point

Conclusions

Irrigations delivered greater surface area and intensity of staining compared with sprays ( P < 0.05)

Assessed approximate surface area stained and quantified surface delivery of methylene blue Head position: spray: forward-tilted position with sprays directed away from septum Irrigation: head-over-sink position Assessed NS and squeeze bottle (50 mL, 100 mL, and200mL) Head position: bending over the sink vs vertex to floor Assessed the distribution of topical pipette (head reclined as much as possible), NS, and system producing squirts Assessed distribution of topical dye in neutral position with radial hole inhaler Compared delivery of spray in vertex to floor position for 1 and 5 minutes with atomizer in upright position Detected radiopaque contrast solution in spray vs drops Drops were instilled in the vertex-to-floor position

Lam

2013

5

Cadaveric study

Population: 8

et al 1523

cadaveric heads

Total of 15 nasal sides received

methylene blue solution using spray device and irrigation squeeze bottle

Beule

2013

5

Cadaveric

Population: 15

Nasal irrigation 200 mL stained surface of olfactory region > 100 mL, 50 mL, and spray Bending over the sink stained the OE better than vertex to the floor

et al 1524

cadaveric heads s/p endoscopic modified Lothrop procedure and complete sphenoeth moidectomy

Scheibe

Squirt reached OC in 73% of participants ( P < 0.001)

2008

4

Observational

Population: 15 healthy volunteers

et al 1525

Herranz

2012

4

Observational

Population: 16 healthy volunteers

No nasal gel was found at theOC

Gonzalez Botas and Seara 1526

Vertex to floor position with 5 minutes had a significant increase of spray delivery to the OC( P = 0.012) penetrated by either spray or drops > 50%of the time and there was no significant difference between the 2methods ( P > 0.05) No significant difference in delivery to the OC ( P = 0.885) The OC was not

Cannady et al 1547

2005

4

Observational

Population: 6 patients

post-FESS with a total of 11 sides

Rudman et al 1528

2011

4

Observational

Population: 9 volunteers

Manes

2011

5

Cadaveric

Population: 5 cadavers

Investigated the

et al 1529

distribution of aerosol delivered via powered

nasal nebulizer in unoperated nose,

post-FESS, and post-FESS with endoscopic modified Lothrop procedure Head position: head tilted 45 degrees downward and the chamber at a 30-degree angle to the face

(Continues)