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 adm inistered 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.