{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T23:24:48Z","timestamp":1788909888213,"version":"build-2803163510"},"reference-count":51,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,11,22]],"date-time":"2023-11-22T00:00:00Z","timestamp":1700611200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82000954"],"award-info":[{"award-number":["82000954"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Laryngoscope Investig Oto"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To compare the deposition patterns within the nasal cavity between the bi\u2010directional and unilateral nasal delivery systems. And to summarize the clinical application of the bi\u2010directional nasal drug delivery devices.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data source<\/jats:title><jats:p>PubMed, Cochrane Library, Embase, and Web of Science databases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A scoping review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta\u2010Analysis (PRISMA). We included studies exploring patterns and influencing factors of particle depositions within the nasal cavity among patients, healthy controls, and nose cast models using the bi\u2010directional and unilateral nasal delivery system. The clinical application of the bi\u2010directional delivery devices was also summarized.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 24 studies were included in this review. Bi\u2010directional nasal delivery systems utilize forced exhalation to power the delivery of drugs to deeper areas of the nasal cavity and paranasal sinuses. Unilateral nasal delivery systems included traditional liquid spray pumps, the aerosol mask system, nebulization, and conventional nasal inhalation. Compared with unilateral delivery systems, the bi\u2010directional nasal delivery system provided a more extensive and efficient nasal deposition in the nasal cavity, especially in the olfactory cleft, without lung deposition. Several parameters, including particle size, pulsatile flow, and nasal geometry, could significantly influence nasal deposition. The bi\u2010directional nasal delivery system enables better delivery of steroids or sumatriptan to the sinonasal cavity's high and deep target sites. This bi\u2010directional delivery device demonstrated an effective and well\u2010tolerated treatment that produced high drug utilization, rapid absorption, and sustained symptom improvement among patients with chronic rhinosinusitis (CRS) or migraine.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The bi\u2010directional nasal drug delivery systems demonstrated significantly higher drug deposition in superior and posterior regions of the nasal cavity than unilateral nasal delivery systems. Further studies should explore its potential role in delivering drugs to the olfactory cleft among patients with olfactory disorders and central nervous system diseases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>N\/A.<\/jats:p><\/jats:sec>","DOI":"10.1002\/lio2.1190","type":"journal-article","created":{"date-parts":[[2023,11,24]],"date-time":"2023-11-24T00:23:04Z","timestamp":1700785384000},"page":"1484-1499","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Bi\u2010directional nasal drug delivery systems: A scoping review of nasal particle deposition patterns and clinical application"],"prefix":"10.1002","volume":"8","author":[{"given":"Yuxing","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Peking University Third Hospital  Beijing PR China"},{"name":"Department of Medicine Peking University  Beijing PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4888-3255","authenticated-orcid":false,"given":"Dawei","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Peking University Third Hospital  Beijing PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,11,22]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1159\/000321044"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1023\/B:PHAR.0000026823.82950.ff"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2273.2004.00797.x"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.3390\/ma14071802"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.3390\/pharmaceutics12020138"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1517\/17425247.5.10.1159"},{"issue":"8","key":"e_1_2_8_8_1","first-page":"2088","article-title":"Nose\u2010to\u2010brain transport pathways an overview: potential of nanostructured lipid carriers in nose to brain targeting","volume":"46","author":"Selvaraj K","year":"2018","journal-title":"Artif Cells Nanomed Biotechnol"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.2174\/156720112803529828"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1023\/A:1011933410898"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1089\/jam.2004.17.249"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13346-012-0108-9"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2021.746420"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.MLG.0000199741.08517.99"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1089\/jamp.2011.0924"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/head.12186"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41582-021-00509-5"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1080\/17512433.2017.1339600"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11095-017-2280-6"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmedt.2022.924501"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1089\/jamp.2019.1549"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejps.2018.03.027"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1089\/jamp.2016.1295"},{"issue":"2","key":"e_1_2_8_24_1","first-page":"175","article-title":"Deposition of drugs in the nose and sinuses with an exhalation delivery system vs conventional nasal spray or high\u2010volume irrigation in Draf II\/III post\u2010surgical anatomy","volume":"58","author":"Djupesland PG","year":"2020","journal-title":"Rhinology"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijpharm.2019.04.019"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.4193\/Rhin09.024"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.4193\/Rhino09.178"},{"issue":"1","key":"e_1_2_8_28_1","first-page":"25","article-title":"EXHANCE\u20103: a cohort study of the exhalation delivery system with fluticasone for chronic sinusitis with or without nasal polyps","volume":"58","author":"Sher MR","year":"2020","journal-title":"Rhinology"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.22141"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1177\/1945892418810281"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2018.06.010"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.23043"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.22693"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1211\/jpp.61.09.0012"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/head.12583"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/head.13105"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/head.13165"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1177\/0333102409359314"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1111\/head.12472"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13346-020-00891-5"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40463-020-00459-w"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.1089\/ped.2019.1066"},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1468-2982.2000.00082.x"},{"key":"e_1_2_8_44_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4610.2007.00805.x"},{"key":"e_1_2_8_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2013.07.021"},{"key":"e_1_2_8_46_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.22292"},{"key":"e_1_2_8_47_1","doi-asserted-by":"publisher","DOI":"10.1111\/head.13199"},{"key":"e_1_2_8_48_1","doi-asserted-by":"publisher","DOI":"10.1517\/17425247.2015.1060959"},{"key":"e_1_2_8_49_1","doi-asserted-by":"publisher","DOI":"10.1038\/jcbfm.2012.126"},{"key":"e_1_2_8_50_1","doi-asserted-by":"publisher","DOI":"10.1021\/acs.molpharmaceut.0c00495"},{"key":"e_1_2_8_51_1","doi-asserted-by":"publisher","DOI":"10.1517\/17425247.2015.1065812"},{"key":"e_1_2_8_52_1","doi-asserted-by":"publisher","DOI":"10.4193\/Rhino16.195"}],"container-title":["Laryngoscope Investigative Otolaryngology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lio2.1190","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,4]],"date-time":"2024-01-04T09:48:55Z","timestamp":1704361735000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lio2.1190"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,22]]},"references-count":51,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2023,12]]}},"alternative-id":["10.1002\/lio2.1190"],"URL":"https:\/\/doi.org\/10.1002\/lio2.1190","archive":["Portico"],"relation":{},"ISSN":["2378-8038","2378-8038"],"issn-type":[{"value":"2378-8038","type":"print"},{"value":"2378-8038","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,22]]},"assertion":[{"value":"2023-10-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-11-15","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-11-22","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}