Comparative Analysis of Spreader Grafts and Spreader Flaps on Intranasal Drug Delivery Efficiency to Posterolateral Nasal Wall
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2025
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<jats:p> Background: This study compared the impact of spreader grafts (SG) and spreader flaps (SF) on the transport of intranasal drug delivery to target the posterolateral nasal wall. Method: SG and SF were each performed in sequence on two cadaveric specimens after soft tissue elevation technique. Computed tomography scans were acquired following each procedure to generate anatomic models for computational fluid dynamics simulation of intranasal sprays under the following conditions: inhalation rate (15 and 30 L/min), spray velocity (1, 5, and 10 m/s), spray released location (center, lateral, medial, top, and bottom), head position (upright, tilted-forward, tilted-backward, and supine), and particle diameter (1-100 µm). Percentage of particles deposited on the posterolateral nasal wall were calculated. Results: For Specimen 1, highest posterolateral wall depositions were Pre-Op: left = 74%, right = 74%; SF: left = 53%, right = 22%; SG: left = 60%, right = 61%. For Specimen 2, highest posterolateral wall depositions were Pre-Op: left = 25%, right = 83%; SF: left = 29%, right = 76%; SG: left = 14%, right = 72%. In general, posterolateral wall deposition was higher at 30 L/min inhalation rate and at 1 m/s spray velocity. Conclusions: Drug delivery targeting the posterolateral nasal wall appears to be dependent on many factors. However, midvault nasal reconstruction does not increase drug delivery to the posterolateral nasal wall. </jats:p>
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Kim, MH, HL Martin, YJ Avashia, RM Sicard, H Chiang, CR Woodard, JR Marcus, DO Frank-Ito, et al. (2025). Comparative Analysis of Spreader Grafts and Spreader Flaps on Intranasal Drug Delivery Efficiency to Posterolateral Nasal Wall. FACE. 10.1177/27325016241310616 Retrieved from https://hdl.handle.net/10161/32013.
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Scholars@Duke
Harry Chiang
Charles Woodard
I am Professor and Division Chief of Facial Plastic & Reconstructive Surgery as well as Division Chief of Comprehensive Otolaryngology for the Department of Head and Neck Surgery & Communication Sciences. I also serve as the Otolaryngology Residency Program Director and Chair of Accreditation Subcommittee for Duke Graduate Medical Education.
My clinical interests include aesthetic and functional reconstruction of the face. My research has focused on value-base care for surgical specialists, quality improvement through outcomes analysis, interdisciplinary facial plastic surgery education, opportunity costs of craniofacial trauma care, computational fluid dynamics evaluation of the nasal airway, and optical spectroscopy evaluation of cutaneous malignancies. An important component of my career success lies in leadership development, so I may remain effective in my current roles at Duke.
Jeffrey Robert Marcus
My research parallels our specialized clinical programs at Duke. I am involved in clinical research looking comprehensively at outcomes of cleft care to develop standards for evaluating a team’s overall success. Based on a recent grant from the Centers for Disease Control (CDC), we are also participating with several centers to look specifically at academic, psychosocial, and surgical outcomes for all children with clefts born in North Carolina. We are committed to the technique of nasoalveolar molding for children with clefts and are engaged in analyzing its benefits. In rhinoplasty, we have developed a model for nasal respiratory physiology, and we are looking at the effects of specific surgical procedures on nasal airflow and resistance. Our Craniofacial imaging lab has developed sophisticated software to analyze cranial shape, and we use these techniques to define abnormal conditions and their treatment relative to normal. Lastly, our craniomaxillofacial trauma team continues to look at factors associated with facial trauma in North Carolina in order to implement techniques and processes to deliver optimal care and results.
Dennis Onyeka Frank-Ito
My research interests include modeling the effects of human airway anatomy on respiratory airflow patterns, deposition of inhaled gases and particle transport using computational fluid dynamics.
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