The use of radiographs to evaluate shoulder pain in the ED

There is general agreement that the delivery of topical nasal medication by sprays is suboptimal. This study examines the distribution of spray to the anterior end of the middle turbinate as a guide to the distribution to the middle meatus by means of an endoscopic photographic comparison using dyed aqueous nasal spray. The technique was found to be reproducible. The effect of vigorously inhaling whilst spraying was studied by means of a randomized crossover trial and was found to have no significant effect. This technique could be used in conjunction with other means of assessing intranasal distribution when assessing improved topical nasal drug delivery systems.