(0300) A Novel Method for Intranasal Drug Delivery: Utility Prior to Nasopharyngoscopy or Surgery

Introduction: Intranasal surgeries and upper airway endoscopy account for millions of cases per year. The anterior nasal vestibule of these patients is often colonized with various pathogenic bacteria such as methicillin resistant S. Aureus or other. Sterilizing the nasal and sinus passages is not possible, however the simplest prepping procedures for cleansing, numbing and decongesting the nose prior to scoping and/or surgery has not been established or standardized. We evaluated a novel intranasal drug delivery system to prep the nose prior to routine in-office procedures or surgery.

Methods: Following informed consent, 30 pre-procedure patients were prepped using a novel drug delivery system (Silicon Valley Innovations, Inc, Sunnyvale, CA). The proprietary antiseptic gel contained phenylephrine, lidocaine, and emollients in an aloe vera gel. Baseline vitals including BP, pulse and oxygen saturation were monitored before, during and after the procedure. A subgroup of patients underwent 4-phase rhinomanometry at 150 Pa - at baseline and after 10 minutes of intranasal application of the gel. Trans nasal pressure and nasal airflow were measured. All patients completed a survey rating the procedure beginning with nasal prep.

Results: Over 90% of patients from this study showed excellent tolerance for intranasal prep using this method. Photographs of the turbinates documented the efficacy of the phenylephrine at 0.5% and the concentration of lidocaine was sufficient to provide a comfortable patient experience. No side effects were noted. Rhinomanometry documented improvement in nasal airflow - quantitatively documenting the decongestant effects of the phenylephrine gel.

Conclusions: This new method of intranasal drug delivery integrated easily into current protocols and proved to be a cost effective, comfortable and convenient approach for presurgical and pre-procedure patients, providing nasal decontamination and decongestion. Further evaluation with an expanded patient cohort is warranted.