Skip to main content
Top
Published in: European Archives of Oto-Rhino-Laryngology 4/2016

01-04-2016 | Rhinology

The administration of nasal drops in the “Kaiteki” position allows for delivery of the drug to the olfactory cleft: a pilot study in healthy subjects

Authors: Eri Mori, Christos Merkonidis, Mandy Cuevas, Volker Gudziol, Yoshinori Matsuwaki, Thomas Hummel

Published in: European Archives of Oto-Rhino-Laryngology | Issue 4/2016

Login to get access

Abstract

Systemic treatment with corticosteroids shows therapeutic effects, few patients benefit from intranasal topical drug application, probably due to limited access of the drug to the olfactory epithelium. The aim of the present study was to investigate how drops distribute within the nasal cavity when the “Kaiteki” position is performed. Thirteen healthy volunteers participated. Subjects were lying on the side with the head tilted and the chin turned upward. Blue liquid was used to visualize the intranasal distribution of the nasal drops. The investigation was carried out using photo documentation thorough nasal endoscopy; the intranasal distribution of the dye was judged by two independent observers in both a decongested state and a natural state where no decongestants had been used. With regard to the main criterion of this study, using the “Kaiteki” position, nasal drops reached the olfactory cleft in 96 % of the decongested cases and 75 % of the cases who had not been decongested. However, this difference was not statistically different. Because the “Kaiteki” maneuver is not too difficult to perform, it is more likely that topical steroids can be helpful in cases of olfactory loss.
Literature
1.
go back to reference Landis BN, Konnerth CG, Hummel T (2004) A study on the frequency of olfactory dysfunction. Laryngoscope 114:1764–1769CrossRefPubMed Landis BN, Konnerth CG, Hummel T (2004) A study on the frequency of olfactory dysfunction. Laryngoscope 114:1764–1769CrossRefPubMed
2.
go back to reference Brämerson A, Johansson L, Ek L, Nordin S, Bende M (2004) Prevalence of olfactory dysfunction: the Skövde population-based study. Laryngoscope 114:733–737CrossRefPubMed Brämerson A, Johansson L, Ek L, Nordin S, Bende M (2004) Prevalence of olfactory dysfunction: the Skövde population-based study. Laryngoscope 114:733–737CrossRefPubMed
3.
go back to reference Murphy C, Schubert CR, Cruickshanks KJ, Klein BE, Klein R, Nondahl DM (2002) Prevalence of olfactory impairment in older adults. JAMA 288:2307–2312CrossRefPubMed Murphy C, Schubert CR, Cruickshanks KJ, Klein BE, Klein R, Nondahl DM (2002) Prevalence of olfactory impairment in older adults. JAMA 288:2307–2312CrossRefPubMed
4.
go back to reference Damm M, Temmel A, Welge-Lüssen A, Eckel HE, Kreft MP, Klussmann JP, Gudziol H, Hüttenbrink KB, Hummel T (2004) Epidemiologie und Therapie von Riechstörungen in Deutschland. Österreich und der Schweiz. HNO 52:112–120 Damm M, Temmel A, Welge-Lüssen A, Eckel HE, Kreft MP, Klussmann JP, Gudziol H, Hüttenbrink KB, Hummel T (2004) Epidemiologie und Therapie von Riechstörungen in Deutschland. Österreich und der Schweiz. HNO 52:112–120
5.
go back to reference Heilmann S, Hüttenbrink KB, Hummel T (2004) Local and systemic administration of corticosteroids in the treatment of olfactory loss. Am J Rhinol 18:29–33PubMed Heilmann S, Hüttenbrink KB, Hummel T (2004) Local and systemic administration of corticosteroids in the treatment of olfactory loss. Am J Rhinol 18:29–33PubMed
6.
go back to reference Scheibe M, Bethge C, Witt M, Hummel T (2008) Intranasal administration of drugs. Arch Otorhinolaryngol Head Neck Surg 134:643–646CrossRef Scheibe M, Bethge C, Witt M, Hummel T (2008) Intranasal administration of drugs. Arch Otorhinolaryngol Head Neck Surg 134:643–646CrossRef
7.
go back to reference Lam K, Tan BK, Lavin JM, Meen E, Conley DB (2013) Comparison of nasal sprays and irrigations in the delivery of topical agents to the olfactory mucosa. Laryngoscope 123:2950–2957CrossRefPubMed Lam K, Tan BK, Lavin JM, Meen E, Conley DB (2013) Comparison of nasal sprays and irrigations in the delivery of topical agents to the olfactory mucosa. Laryngoscope 123:2950–2957CrossRefPubMed
8.
go back to reference Miyazaki J, Matsushita H, Yamada S, Inokuchi A (2004) New method for effective instillation of nasal drops in patients with olfactory dysfunction. Pract Oto-Rhino-Laryngol 97:697–705CrossRef Miyazaki J, Matsushita H, Yamada S, Inokuchi A (2004) New method for effective instillation of nasal drops in patients with olfactory dysfunction. Pract Oto-Rhino-Laryngol 97:697–705CrossRef
9.
go back to reference Kubba H, Spinou E, Robertson A (2000) The effect of head position on the distribution of drops within the nose. Am J Rhinol 14:83–86CrossRefPubMed Kubba H, Spinou E, Robertson A (2000) The effect of head position on the distribution of drops within the nose. Am J Rhinol 14:83–86CrossRefPubMed
10.
go back to reference Benninger MS, Hadley JA, Osguthorpe JD, Marple BF, Leopold DA, Derebery MJ, Hannley M (2004) Techniques of intranasal steroid use. Otolaryngol Head Neck Surg 130:5–24CrossRefPubMed Benninger MS, Hadley JA, Osguthorpe JD, Marple BF, Leopold DA, Derebery MJ, Hannley M (2004) Techniques of intranasal steroid use. Otolaryngol Head Neck Surg 130:5–24CrossRefPubMed
11.
go back to reference Shu CH, Lee PL, Shiao AS, Chen KT, Lan MY (2012) Topical corticosteroid applied with a squirt system being more effective than with nasal spray for steroid-dependent olfactory impairment. Laryngoscope 122:747–750CrossRefPubMed Shu CH, Lee PL, Shiao AS, Chen KT, Lan MY (2012) Topical corticosteroid applied with a squirt system being more effective than with nasal spray for steroid-dependent olfactory impairment. Laryngoscope 122:747–750CrossRefPubMed
12.
go back to reference Blomqvist EH, Lundblad L, Bergstedt H, Stjarne P (2003) Placebo-controlled, randomized, double-blind study evaluating the efficacy of fluticasone propionate nasal spray for the treatment of patients with hyposmia/anosmia. Acta Otolaryngol 123:862–868CrossRefPubMed Blomqvist EH, Lundblad L, Bergstedt H, Stjarne P (2003) Placebo-controlled, randomized, double-blind study evaluating the efficacy of fluticasone propionate nasal spray for the treatment of patients with hyposmia/anosmia. Acta Otolaryngol 123:862–868CrossRefPubMed
13.
go back to reference Klimek L, Hummel T, Moll B, Kobal G, Mann WJ (1998) Lateralized and bilateral olfactory function in patients with chronic sinusitis compared with healthy control subjects. Laryngoscope 108:111–114CrossRefPubMed Klimek L, Hummel T, Moll B, Kobal G, Mann WJ (1998) Lateralized and bilateral olfactory function in patients with chronic sinusitis compared with healthy control subjects. Laryngoscope 108:111–114CrossRefPubMed
14.
go back to reference Kayarkar R, Clifton NJ, Woolford TJ (2002) An evaluation of the best head position for instillation of steroid nose drops. Clin Otolaryngol Allied Sci 27:18–21CrossRefPubMed Kayarkar R, Clifton NJ, Woolford TJ (2002) An evaluation of the best head position for instillation of steroid nose drops. Clin Otolaryngol Allied Sci 27:18–21CrossRefPubMed
15.
go back to reference Karagama YG, Lancaster JL, Karkanevatos A, O’Sullivan G (2001) Delivery of nasal drops to the middle meatus: which is the best head position? Rhinology 39:226–229PubMed Karagama YG, Lancaster JL, Karkanevatos A, O’Sullivan G (2001) Delivery of nasal drops to the middle meatus: which is the best head position? Rhinology 39:226–229PubMed
16.
go back to reference Wolfensberger M, Hummel T (2002) Anti-inflammatory and surgical therapy of olfactory disorders related to sino-nasal disease. Chem Senses 27:617–622CrossRefPubMed Wolfensberger M, Hummel T (2002) Anti-inflammatory and surgical therapy of olfactory disorders related to sino-nasal disease. Chem Senses 27:617–622CrossRefPubMed
17.
18.
go back to reference Vandenhende-Szymanski C, Hochet B, Chevalier D, Mortuaire G (2015) Olfactory cleft opacity and CT score are predictive factors of smell recovery after surgery in nasal polyposis. Rhinology 53:29–34PubMed Vandenhende-Szymanski C, Hochet B, Chevalier D, Mortuaire G (2015) Olfactory cleft opacity and CT score are predictive factors of smell recovery after surgery in nasal polyposis. Rhinology 53:29–34PubMed
Metadata
Title
The administration of nasal drops in the “Kaiteki” position allows for delivery of the drug to the olfactory cleft: a pilot study in healthy subjects
Authors
Eri Mori
Christos Merkonidis
Mandy Cuevas
Volker Gudziol
Yoshinori Matsuwaki
Thomas Hummel
Publication date
01-04-2016
Publisher
Springer Berlin Heidelberg
Published in
European Archives of Oto-Rhino-Laryngology / Issue 4/2016
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-015-3701-y

Other articles of this Issue 4/2016

European Archives of Oto-Rhino-Laryngology 4/2016 Go to the issue