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\begin{document}

\title{A Comparison between Mygind and Kaiteki positions in administration of
drops to the olfactory cleft}



\author[1]{Dafna  Milk}%
\author[2]{Grace Khong}%
\author[3]{Osman CAM}%
\author[4]{Fernando Alfaro-Iraheta }%
\author[5]{Claire Tierney}%
\author[1]{Firas Kassem}%
\author[6]{Samuel Leong}%
\affil[1]{Meir Medical Center}%
\affil[2]{Fairfield General Hospital}%
\affil[3]{Aintree University Hospitals NHS Foundation Trust}%
\affil[4]{The Liverpool Head and Neck Centre, United Kingdom}%
\affil[5]{University of Liverpool Human Anatomy Resource Centre}%
\affil[6]{University Hospital Aintree}%


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  \date{May 25, 2024}


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\begin{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\textgreater{}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.%
\end{abstract}%



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