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A Comparison between Mygind and Kaiteki positions in administration of drops to the olfactory cleft

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A Comparison between Mygind and Kaiteki positions in administration of drops to the olfactory cleft
Dafna G. Milk Grace C. Khong Osman H. Çam Fernando Alfaro‐Iraheta Claire Tierney Firas Kassem Samuel C. Leong
First published: 16 December 2020 https://doi.org/10.1111/coa.13690
The study was performed at the Human Anatomy Resource Center, University of Liverpool, UK
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Abstract
Objectives
Topical nasal steroids are a common treatment intervention for olfactory dysfunction. Penetration of topical treatment to the olfactory cleft (OC), such as nasal drops, is greatly dependent on the position of the head when the treatment is administered. We aimed to examine the penetrance of nasal drops to the OC in two different head positions: the Mygind (lying head back) position and the Kaiteki position.

Design and Setting
The specimens were firstly positioned in Mygind, and thereafter in Kaiteki positions. Nasal drops mixed with blue food dye were administered into the nostrils in each of the 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
Penetration of the dye into the OC.

Results
The mean score of nasal drops penetrance to the OC in the Mygind position was 1.34 (standard deviation, SD = 0.92), as compared to 1.76 (SD = 0.65) in the Kaiteki position. The difference in the OCP score between the two groups was not statistically significant (P > .05).

Conclusion
Both Mygind and Kaiteki head positions are reasonable options for patients considering topical nasal drops for olfaction impairment. The preference of one position over the other should be determined by patient's preference and comfort.

Open Research

Volume46, Issue2

March 2021

Pages 406-411

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© 2021 John Wiley & Sons Ltd


Keywords
anosmia nasal drops olfaction olfactory cleft
Publication History
Issue Online:
23 February 2021
Version of Record online:
03 January 2021
Accepted manuscript online:
16 December 2020
Manuscript accepted:
29 November 2020
Manuscript revised:
07 November 2020
Manuscript received:
18 July 2020
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Rhinology
Published: 04 July 2015
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
Eri Mori, Christos Merkonidis, Mandy Cuevas, Volker Gudziol, Yoshinori Matsuwaki & Thomas Hummel
European Archives of Oto-Rhino-Laryngology volume 273, pages939–943(2016)Cite this article

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10 Citations

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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 decong ested. 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.

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