Skip to main content
SpringerLink
Log in

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

  • Rhinology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Landis BN, Konnerth CG, Hummel T (2004) A study on the frequency of olfactory dysfunction. Laryngoscope 114:1764–1769

    Article  CAS  PubMed  Google Scholar 

  2. Brämerson A, Johansson L, Ek L, Nordin S, Bende M (2004) Prevalence of olfactory dysfunction: the Skövde population-based study. Laryngoscope 114:733–737

    Article  PubMed  Google Scholar 

  3. Murphy C, Schubert CR, Cruickshanks KJ, Klein BE, Klein R, Nondahl DM (2002) Prevalence of olfactory impairment in older adults. JAMA 288:2307–2312

    Article  PubMed  Google Scholar 

  4. 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

    CAS  Google Scholar 

  5. Heilmann S, Hüttenbrink KB, Hummel T (2004) Local and systemic administration of corticosteroids in the treatment of olfactory loss. Am J Rhinol 18:29–33

    PubMed  Google Scholar 

  6. Scheibe M, Bethge C, Witt M, Hummel T (2008) Intranasal administration of drugs. Arch Otorhinolaryngol Head Neck Surg 134:643–646

    Article  Google Scholar 

  7. 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 123:2950–2957

    Article  PubMed  Google Scholar 

  8. 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 97:697–705

    Article  Google Scholar 

  9. Kubba H, Spinou E, Robertson A (2000) The effect of head position on the distribution of drops within the nose. Am J Rhinol 14:83–86

    Article  CAS  PubMed  Google Scholar 

  10. Benninger MS, Hadley JA, Osguthorpe JD, Marple BF, Leopold DA, Derebery MJ, Hannley M (2004) Techniques of intranasal steroid use. Otolaryngol Head Neck Surg 130:5–24

    Article  PubMed  Google Scholar 

  11. 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 122:747–750

    Article  CAS  PubMed  Google Scholar 

  12. 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 123:862–868

    Article  CAS  PubMed  Google Scholar 

  13. 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 108:111–114

    Article  CAS  PubMed  Google Scholar 

  14. Kayarkar R, Clifton NJ, Woolford TJ (2002) An evaluation of the best head position for instillation of steroid nose drops. Clin Otolaryngol Allied Sci 27:18–21

    Article  CAS  PubMed  Google Scholar 

  15. 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 39:226–229

    CAS  PubMed  Google Scholar 

  16. Wolfensberger M, Hummel T (2002) Anti-inflammatory and surgical therapy of olfactory disorders related to sino-nasal disease. Chem Senses 27:617–622

    Article  PubMed  Google Scholar 

  17. Pade J, Hummel T (2008) Olfactory function following nasal surgery. Laryngoscope 118:1260–1264

    Article  PubMed  Google Scholar 

  18. 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 53:29–34

    CAS  PubMed  Google Scholar 

Download references

Acknowledgments

This study did not receive any external support. None of the authors have a conflict of interest. All authors had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Author information

Authors and Affiliations

  1. Department of Otorhinolaryngology, Smell and Taste Clinic, TU Dresden, Fetscherstrasse 74, 01307, Dresden, Germany

    Eri Mori, Christos Merkonidis, Mandy Cuevas, Volker Gudziol & Thomas Hummel

  2. Department of Otorhinolaryngology, The Jikei University School of Medicine, Tokyo, Japan

    Eri Mori & Yoshinori Matsuwaki

Authors
  1. Eri Mori
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Christos Merkonidis
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mandy Cuevas
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Volker Gudziol
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yoshinori Matsuwaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Thomas Hummel
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Thomas Hummel.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Mori, E., Merkonidis, C., Cuevas, M. et al. 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. Eur Arch Otorhinolaryngol 273, 939–943 (2016). https://doi.org/10.1007/s00405-015-3701-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-015-3701-y

Keywords

Search

Navigation