{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T18:31:56Z","timestamp":1786386716787,"version":"build-2736575974"},"reference-count":26,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T00:00:00Z","timestamp":1767139200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T00:00:00Z","timestamp":1767139200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Subglottic stenosis (SGS) coexists with bronchopulmonary disease, complicating topical therapy given the distinct anatomical targets. Optimizing inhaled medication delivery to both regions remain a therapeutic challenge. This study evaluates the ability of orally inhaled aerosol particles to achieve dual\u2011site deposition in SGS and bronchopulmonary regions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Computational modeling of orally inhaled drug particle delivery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Academic Medical Center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Digitally modified airways simulating 8 SGS variants, combining McCaffrey Stage I (5\u2009mm) and II (15\u2009mm) subglottic lengths with Cotton\u2011Myer Grade I (10%, 30%), Grade II (60%), and Grade III (90%) luminal constrictions. Oral inhalation at 15\u2009L\/min and particle transport were simulated for fluticasone propionate (FP; mean aerosol velocity 9.19\u2009m\/s, particle size range 1\u20108\u2009\u03bcm) and ciclesonide\u00a0(CIC; mean aerosol velocity 4.26\u2009m\/s, particle size range 1\u20104\u2009\u03bcm) inhaler characteristics, and 6 particle\u2011size distributions M\n                      <jats:sub>1<\/jats:sub>\n                      (1\u20105\u2009\u03bcm), M\n                      <jats:sub>2<\/jats:sub>\n                      (6\u201010\u2009\u03bcm), M\n                      <jats:sub>3<\/jats:sub>\n                      (1\u201010\u2009\u03bcm) while maintaining the respective parent (CIC and FP) mean aerosol velocity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In the normal airway, CIC and FP inhalers achieved &gt;80% bronchial deposition but \u22640.02% subglottic delivery. Among modified devices, M\n                      <jats:sub>2<\/jats:sub>\n                      CIC optimized dual targeting, providing the highest subglottic deposition (0.09%) with preserved bronchial efficiency (69.46%). In SGS models, M\n                      <jats:sub>2<\/jats:sub>\n                      CIC and M\n                      <jats:sub>2<\/jats:sub>\n                      FP consistently achieved the most balanced delivery, with maximum deposition of M\n                      <jats:sub>2<\/jats:sub>\n                      CIC\u2009=\u20098.4% and M\n                      <jats:sub>2<\/jats:sub>\n                      FP\u2009=\u20097.86% at subglottic region, and M\n                      <jats:sub>2<\/jats:sub>\n                      CIC\u2009=\u200969.89% and M\n                      <jats:sub>2<\/jats:sub>\n                      FP\u2009=\u200961.02% at bronchial site. M\n                      <jats:sub>3<\/jats:sub>\n                      variants offered intermediate dual deposition at advanced and Grade III stenosis stages.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      M\n                      <jats:sub>2<\/jats:sub>\n                      CIC and M\n                      <jats:sub>2<\/jats:sub>\n                      FP inhaler modifications optimized dual\u2010site supporting tailored device strategies for SGS with coexisting bronchopulmonary disease.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ohn.70097","type":"journal-article","created":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T13:07:37Z","timestamp":1767186457000},"page":"479-488","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Investigating the Challenges of Managing Coexisting Subglottic Stenosis and Bronchopulmonary Diseases Medically Using Computational Modeling"],"prefix":"10.1002","volume":"174","author":[{"given":"Kerry","family":"Gao","sequence":"first","affiliation":[{"name":"Duke University School of Medicine Durham North Carolina USA"},{"name":"Department of Head and Neck Surgery &amp; Communication Sciences Duke University Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan A.","family":"Luzum","sequence":"additional","affiliation":[{"name":"Duke University School of Medicine Durham North Carolina USA"},{"name":"Department of Head and Neck Surgery &amp; Communication Sciences Duke University Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seth","family":"Cohen","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery &amp; Communication Sciences Duke University Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9683-8355","authenticated-orcid":false,"given":"Dennis O.","family":"Frank\u2010Ito","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery &amp; Communication Sciences Duke University Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,31]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-198209000-00002"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348941212100704"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.25417"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.95.4.567"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1017\/S002221511300025X"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.23771"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.29783"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-023-08141-3"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2019.11.43"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2015.05.079"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2021.106582"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25708"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24287"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26097"},{"key":"e_1_2_8_16_1","first-page":"4","article-title":"Corticosteroids for the prevention and treatment of bronchopulmonary dysplasia: an overview of systematic reviews","author":"Loo M","year":"2024","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_8_17_1","doi-asserted-by":"crossref","unstructured":"JanahiIA RehmanA BalochNUA.Corticosteroids and their use in respiratory disorders. 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