• H M Janssens and H A W Tiddens.
• Department of Pediatric Pulmonology, Erasmus Medical Center, Sophia Children's Hospital, Rotterdam, The Netherlands. H.Janssens@erasmusmc.nl
• J Aerosol Med. 2007 Jan 1;20 Suppl 1:S59-63; discussion S63-5.

AbstractA 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.

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