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The 'best method' of topical nasal drug delivery: comparison of seven techniques.

OBJECTIVE
To determine whether there is a 'best' technique for delivering drugs to the middle meatus.


DESIGN
Single-blind cross-over study in healthy individuals using endoscopic video-imaging.


PARTICIPANTS
A dyed test formulation was administered intranasally on seven non-sequential days to ten healthy individuals with no 'nasal' history. The participants were recruited through advertisement.


MAIN OUTCOME MEASURES
Comparison of seven different techniques, 20 nostrils and 140 endoscopic videos for the deposition patterns of dyed test formulation. Analysis was possible in 90% of all endoscopic videos. Three head positions were tested for both nasal drops and nasal sprays.


RESULTS
Deposition of dyed test formulation near the middle meatus was observed in 43% of all observations. No significant differences were observed in terms of delivery between any of the seven techniques.


CONCLUSIONS
Our study suggests there may not be a single 'best' technique for topical nasal drug delivery. A more individual approach to topical nasal drug treatment, taking anatomy and head position into account would seem to be more appropriate.