Otolaryngology: Open Access
Open Access

Abstract

The main objective of this presentation is to offer a comprehensive, updated overview of nano-othorhinolaringology, addressing its main issues, the current solutions and the future perspectives. The introduction of nanobiotechnologies has revolutionized the field of internal medicine, enabling a personalized treatment of the disease instead of the conventional ?onesize- fits-all? management. Both ear and nasal cavity have a highly compartmentalized anatomy, which makes drug delivery particularly challenging. Specifically, drug delivery may be limited from a poor absorption from the nose and the ear, which may be further complicated by the pathophysiological condition of the patient. Biotechnologies and genetic engineering as well as bioinformatics are giving encouraging results in the treatment and control of head and neck cancer, by elucidating the pathogenesis at a molecular level and enabling physicians to treat the patient at the nanoscale. Since the pioneering work of Ellis-Behnke and collaborators, who developed a nanobiotechnological-enabled solution to stop bleeding during surgery, which could be for example used in the treatment of epistaxis, nano-otorhinolaringology has much evolved. Novel nanosized drugs are thought to be ideal vehicles that could overcome the above-.mentioned limitations: Nano-objects, such as carbon nanotubes, nanogels, nanodisks, liposomes, polymersomes, lipidicnanocapsules, ethosomes and poly(lactic-co-glycolic acid) (PLGA) or chitosan nanoparticles could provide an efficient means for drug transfer in the ear and nose. These new-generation approaches may increase drug delivery efficiency, since these drugs are more stable and more effective. Moreover, in the ear and in the nose these vector systems are specifically uptaken into highly specialized cells, targeting cell-surface receptors and cell signaling pathways. New formulation of amphotericin B, such as polyene antibiotic amphotericin B (AMB), one of the first nanotherapeutic agents to be approved and commercially released, are showing promising results against chronic Rhinosinusitis. Nanoporous coatings of implants, such as cochlear implants, represent an important solution for topical delivery of drugs, in that they could alleviate post-surgical complications of a particularly invasive surgery, such as infections. Many variables, including formulation and the physiochemical parameters of the drugs, can be finely tuned, in terms of the amount and duration of drug release. Drug release profile could be indeed ad hoc optimized by exploiting mathematical modeling (for example, differential equations and artificial neural networks), or simulations (such as molecular dynamics). Last but not least, biosafety remains an issue to be addressed, since long-term safety of these vectors has not yet been investigated. For this reason, the nanotoxicology calls for continuous caution to monitor, control and prevent any adverse effect in the future.

Biography

Nicola Luigi Bragazzi is currently a MD, MSc, PhD and a resident in Public Health. He got his MD (medical degree) on the 15th of July in 2011 cum laude with a thesis on Personalized Nanomedicine (?Nanomolecular aspects of medicine, at the cutting-edge of the nanobiosciences in the field of health-care?) and the joint Italo-Russian MSc (Master of Science) in Nanobiotechnologies at Lomonosov Moscow State University (27th April 2012). He got his PhD in Nanochemistry and Nanobiotechnology at Marburg University, Germany and is currently a resident in Public Health at University of Genoa, Italy, 3rd year. He is author and/or co-author of several publications.