An experimental study of the effect of individual upper airway anatomical features on the deposition of dry powder inhaler formulations

This study aims to investigate the effects of different pharynx anatomical features on the delivery of inhaled aerosols. Six in-vitro upper airway models reconstructed using anatomical images acquired by Magnetic Resonance Imaging (MRI) were used for the experiments. A geometrically accurate airway model was produced, and five other different airway models, each missing one or more specific anatomical features: the uvula, epiglottis, and/or soft palate, were derived from the original model. Hence, the geometrical boundaries of the six models were the same except at regions where specific anatomical structures were removed, and this was done to allow meaningful comparisons between the different geometries to be made using specific measurements. Spray-dried mannitol powder (volume median particle size and span were 3.22 μm and 1.90 μm, respectively) was loaded into a capsule-based dry powder inhaler with different resistance, an Osmohaler™ (low resistance), or Handihaler® (high resistance), attached to the inlet of the airway model, which its outlet was connected to a Next-Generation Impactor (NGI). The studies were performed using flow rates of 30 and 60 LPM. High-performance liquid chromatography (HPLC) was used to quantify the mass deposition of particles in different stages of the NGI and airway replicas. Results from this study show that widening the space between the oral cavity and oropharynx, exemplified by one of the six replicas developed, significantly decreases upper airway deposition as well as increases the fine particle fraction. The case with the highest deposition (63.5%) occurred in the pharynx replica with the soft palate present (at 60 LPM with the Hanihaler), while the lowest deposition (26.0%) occurred in the replica without the soft palate and epiglottis (at 30 LPM with the Osmohaler). This study highlights that in addition to the resistance of the inhalers, their interactions with the human airway anatomical features are likely to play important roles in the subsequent lung dose. Results from this study are novel because while the effects of different inhaler resistance in a given airway replica is known, the effects contributed by specific pharynx anatomical features on particle transport behaviour have not been studied experimentally or reported on in the literature. This study shows that space adjacent to the soft palate affects particle deposition dramatically but the effect appears to be more significant when using the Handihaler and for the high flow rate cases.