A better technique for nasal sprays

Viral respiratory infections start at the nose. The nasal cavity lining is rich in ACE2 receptors, where the SARS-CoV-2 virus, the cause of COVID-19, can attach to enter the cells and begin viral replication.

The article, Nasal rinse and deep gargle stop viral respiratory infections in their tracts, talks about using saline solutions, diluted povidone-iodine, and hydrogen peroxide. Nasal sprays are also helpful since they are more portable and can be used anywhere. 

Engineers from several universities in the US proposed a more efficient way to use nasal sprays. The main targets when using nasal sprays are the nasopharynx which is the back part of the nasal cavity.

Below is the image of the wall of the right nasal cavity as seen on the inside. The nasopharynx is pink. Nasopharynx-associated lymphatic tissue (NALT) is involved in stopping infections.

The other area where medications should go is the osteomeatal complex (OMC). The OMC inside the nasal cavity is where the ethmoid, maxillary, and frontal sinuses drain. Those sinus cavities are also breeding grounds for viral infections. Sinusitis happens when the sinuses are inflamed.

The figure is a CT scan image of the face when looking at the front. The bones are white and soft tissues are gray. The two big round objects are the eyes, and the middle is the nasal cavity with the turbinates. I circled the osteomeatal complex in red. The side of the nose on your left is a congested nose. The black areas are the maxillary sinus.

Typically,  the standard way or “Current Use” (CU) of nasal sprays is where the nozzle enters the nose almost vertically and towards the middle of the nose.

The study, A model-based approach to improve intranasal sprays for respiratory viral infections, the preprint study is on medRxiv. It has not been peer-reviewed. I read it, and it makes a lot of medical science to me. 

The engineers tested the effectiveness of the new technique that they called the “Improved Use” (IU) method that entails pointing the spray bottle at a shallower angle (almost horizontally) and towards the cheeks. 

The image below compares the “Current Use” (CU) and the “Improved Use” (IU). Notice that the IU has a greater chance of delivering the droplets to the nasopharynx that’s in blue.

Their result shows that the “Improved Use” technique is more efficient at targeting the “hot spots” for viral infections in the nasal cavity by nearly a hundred-fold.

With the “Improved Use” technique, the droplets are efficiently delivered even with minor changes in spray directions.

The drawing below from the lead author shows the angle and how to hold the nasal spray bottle.

It is easier to use the right hand to spray the left nostril with the same position as shown and vice versa. That will eliminate awkward bending of the elbow and the wrist if the right-hand sprays the right nostril.

Nasal sprays

Povidone-iodine nasal sprays like the Betadine First Aid Spray kills viruses in seconds.

 Deep-Sea Nasal Moisturizing Spray has salt and benzalkonium chloride that kills SARS-CoV-2.

Simply Saline Nasal Mist has baking soda, water, and salt and washes away mucus build-up so that the cells’ ciliary mechanism on the lining of the nose will restart to sweep away dirt along with the germs. It helps with decongesting the nose. 

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The Improved Use technique is also helpful for applying decongestants and anti-allergy nasal sprays.

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