Optimizing topical nasal steroid application in adenoid hypertrophy: A computational fluid dynamics (CFD) analysis

Introduction: Intranasal steroids are effective in managing adenoid hypertrophy in children, but the evidence regarding technique of use for optimal results is lacking.

Methods: CFD analysis, with discrete phase modelling was done to simulate nasal spray in nasal cavity and drug delivery in the region of adenoids. The findings were validated using a 3D model designed from CT scan of the same region.

Results: Our study shows that the maximum spray deposition in the adenoid region is with injection angle of 30° with the concentration value of 14 kg/m³.

Discussion: Nasal steroids have been found to be quite effective in symptoms reduction in children with adenoid hypertrophy. The current guidelines for technique of application are similar to that which has been validated for nasal pathologies. But the studies analyzing optimum drug delivery to the adenoids with variations in technique of application are lacking. This is the research gap we have tried to fill with our study.

Conclusion: The application of nasal steroids with nozzle inclined at 30° with respect to the floor of nose ensures maximum drug delivery to the adenoids and is likely to improve the efficacy of this treatment.