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A Comparison between Mygind and Kaiteki positions in administration of drops to the olfactory cleft
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  • Dafna Milk,
  • Grace Khong,
  • Osman CAM,
  • Fernando Alfaro-Iraheta ,
  • Claire Tierney,
  • Firas Kassem,
  • Samuel Leong
Dafna Milk
Meir Medical Center
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Grace Khong
Fairfield General Hospital
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Osman CAM
Aintree University Hospitals NHS Foundation Trust
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Fernando Alfaro-Iraheta
The Liverpool Head and Neck Centre, United Kingdom
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Claire Tierney
University of Liverpool Human Anatomy Resource Centre
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Firas Kassem
Meir Medical Center
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Samuel Leong
University Hospital Aintree
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Abstract

Objectives: Systemic steroids are a well-known, proven treatment for olfaction impairment. Topical nasal steroids are an attractive alternative that avoids systemic side effects and might provide an increased local drug activity. Nonetheless, the access of the medication to the olfactory cleft (OC) by using low- volume devices, such as nasal drops, is greatly dependent on the position of the head. We aimed to examine the accessibility of nasal drops to the OC area in two different head positions: the Mygind (lying head back) position and the Kaiteki position. Design and Setting: This is a cadaver study; the specimens were firstly positioned in Mygind and thereafter in Kaiteki positions. Nasal drops mixed with blue food dye were administered into the nostril in each head position. Endoscopic videos were recorded, and two blinded observers scored the extent of olfactory cleft penetration (OCP) using a 4-point scale (0 = none, 3 = heavy). Participants: Twelve fresh-frozen cadaver specimens Main outcome measures: The dye’s penetration to the OC Results: The mean score of nasal drops penetrance to the OC in the Mygind position was 1.34, as compared to 1.76 in the Kaiteki position. The difference in the OCP score between the two groups was not statistically significant (p>0.05) Conclusion: Both Mygind and Kaiteki head positions are reasonable alternatives in treatment with nasal drops for olfaction impairment. The preference of one position over another should rely on the patient’s comfort.

Peer review status:IN REVISION

14 Jul 2020Submitted to Clinical Otolaryngology
20 Jul 2020Submission Checks Completed
20 Jul 2020Assigned to Editor
23 Jul 2020Reviewer(s) Assigned
12 Aug 2020Review(s) Completed, Editorial Evaluation Pending
17 Aug 2020Editorial Decision: Revise Major
15 Sep 20201st Revision Received
17 Sep 2020Assigned to Editor
17 Sep 2020Submission Checks Completed