Abstract
Chronic rhinosinusitis is an upper respiratory disease during which topical drug treatment via the nasal cavity is the most actively utilized therapeutic strategy. In addition to steroids, antibiotics, and antifungal agents, which are widely used in clinical practice, research on novel topical agents to improve the bacterial biofilm or mucociliary clearance remains ongoing. Moreover, owing to the complex structure of the nasal cavity, the effects of nasal drug delivery vary depending on factors related to delivery fluid dynamics, including device, volume, and compounds. In this article, we review methods and compounds that have been applied to chronic rhinosinusitis management and introduce recent advances and future perspectives in nasal drug delivery for upper respiratory diseases.
Highlights
Current Perspective on NasalChronic sinusitis (CRS) is a common disease with global prevalence rates of 10.9% in Europe [1], 13% in the United States [2], 6.95% in South Korea [3], and 8% in China [4]
Another meta-analytic study recently claimed that hypertonic saline irrigation is more effective in treating Current Perspective on NasalChronic sinusitis (CRS); there was no difference in smell improvement compared to isotonic saline irrigation [15]
A Cochrane review has evaluated the effects of topical amphotericin B as well as fluconazole in CRS; owing to the low credibility of the available evidence, it cannot be determined with absolute certainty whether the use of topical antifungals has a positive role in patients with CRS [45]
Summary
Chronic sinusitis (CRS) is a common disease with global prevalence rates of 10.9% in Europe [1], 13% in the United States [2], 6.95% in South Korea [3], and 8% in China [4]. A nasal spray is the most commonly used nasal drug delivery equipment, presenting advantages of portability and convenience It has some disadvantages; e.g., the drug may fail to reach the entirety of the sinuses and superior nasal parts, is discharged into the throat by nasal cilia, swallowed into the stomach, or cannot play a role in the treatment of nasal diseases. The problems associated with most nasal drug delivery devices include the particle size of drops or powders, the location and form of drug deposition, and the loss of drugs from the nasal cavity after administration. To resolve these problems, various nasal drug delivery devices with new functions have been developed. Pharmaceutics 2021, 13, 246 characteristics of delivery methods and drugs developed to date and introduces the newly developed devices
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