Facemasks and aerosol delivery by metered dose inhaler-valved holding chamber in young children: a tight seal makes the difference

J Aerosol Med. 2007;20 Suppl 1:S59-63; discussion S63-5. doi: 10.1089/jam.2007.0578.


A facemask on a valved holding chamber (VHC) facilitates the inhalation of aerosols from metered dose inhalers (MDI) for young children. Only recently the facemask has been recognized as a vital part for efficient aerosol delivery. Several in vitro and in vivo studies show that a tight seal of the facemask is crucial for optimal aerosol deposition to the lungs. Even a small leak can reduce the dose delivered to the lungs considerably. However, a tight seal is difficult to obtain when a child is not cooperative. Depending on the design of the facemask, it is easier to obtain a good seal. Factors such as dead space, shape, and material should be considered when designing a facemask. However, when a child is upset and not cooperative during the administration, aerosol deposition will be minimal, even with the best-designed facemask.

Publication types

  • Review

MeSH terms

  • Aerosols / administration & dosage*
  • Child, Preschool
  • Equipment Design
  • Equipment Failure
  • Humans
  • Masks*
  • Metered Dose Inhalers*
  • Patient Compliance


  • Aerosols