Ideoto, LLC

ChitoRhino™&

The CleanWash™ Bottle

Ideoto, LLC

Ideoto, LLC

ChitoRhino™ what’s unique about it?

• Patent pending formulationo ph, balanced saline nasal rinseo infused with CHITOSAN

• Chitosano all natural biopolymer (carbohydrate)o derived from shellfish*o clinically proven and extensively studied for >50 years.

originally discovered in 1859

* hypoallergenic

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Chitosana linear polysaccharide composed of randomly distributed β--linked D-glucosamine and N-acetyl-D-glucosamine.

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o Naturally antibacterialo Naturally anti-fungalo Naturally anti-inflammatoryo Naturally hemostatico Naturally disrupts biofilms

• Aziz MA. Antimicrobial properties of a chitosan dextran-based hydrogel for surgical use. - - Antimicrob Agents Chemother - 01-JAN-2012; 56(1): 280-7.• FEMS Microbiol Lett. 1999 Sep 15;178(2):313-7.Quantitative analysis of the effect of xylitol on pneumococcal nasal colonisation in rats.Kontiokari T, Svanberg M, Mattila P, Leinonen M,

Uhari M.• J Microbiol Biotechnol. 2008 Oct;18(10):1729-34.Investigation of the antifungal activity and mechanism of action of LMWS-chitosan.Park Y, Kim MH, Park SC, Cheong H, Jang MK, Nah JW,

Hahm KS.• J Biomater Sci Polym Ed. 2008;19(8):1035-46. doi: 10.1163/156856208784909372.Anti-biofilm properties of chitosan-coated surfaces.Carlson RP, Taffs R, Davison WM, Stewart PS.• Athanasiadis T. Effects of a novel chitosan gel on mucosal wound healing following endoscopic sinus surgery in a sheep model of chronic rhinosinusitis. - - Laryngoscope - 01-JUN-2008;

118(6): 1088-94• Medina JG. A chitosan-based sinus sealant for reduction of adhesion formation in rabbit and sheep models. - Otolaryngol Head Neck Surg - 01-AUG-2012; 147(2): 357-63• Li L, Wang N, Jin X, et al. Biodegradable and injectable in situ cross-linking chitosan-hyaluronic acid-based hydrogels for postoperative adhesion prevention. Biomaterials. 2014; 35:3903-

3917.• Aziz MA, Cabral JD, Brooks HJL, et al. In vitro biocompatibility and cellular interactions of a chitosan/dextran-based hydrogel for postsurgical adhesion prevention. J Biomed Mater Res. Part

B 2014; 00B:000–000.• Shikani AH, Chahine KA, Alqudah MA. Endoscopically guided chitosan nasal packing for intractable epistaxis. Am J Rhinol Allergy. 2011;25(1):61-63.

Clinical Properties of Chitosan

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Chitosan• Medical devices

o Medtronic – NovaShield® nasal gelo Olympus – PosiSep® nasal packingo CogENT – Xerogel® nasal packingo Medovent GmbH- Germanyo HemCon, Celoxmedical - hemostatic bandage

• Phase III clinical trials– using chitosan as a drug carrier

• Other applications of chitosano water purifying agent/ diet aid/ cosmetics/woven fiber for clothing

Ideoto, LLCMedtronic NovaShield® chitosan gel – intra-operative photo – after sinus surgery

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Chitosan (PosiSep) pack placed during surgery

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Chitosan• Cellular activity

o temporarily breaks tight junctions between cellso polycationic - multiple positive charges

bacteria and fungi are negatively charged promotes disruption of cell walls

• naturally prevents biofilm formation

http://www.novamatrix.biz/Technology/NasalDrugDelivery.aspx

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Chitosan

• Safetyo derived from shellfish - it is a SUGAR not a PROTEIN

no cross reactivity in shellfish allergic patients*

o toxicity less than sucroseo naturally broken down by lysozyme into glucosamine

• Not regulated by FDA - GRS

Waibel KH, et al. Safety of chitosan bandages in shellfish allergic patients. Mil Med 2011 Oct:176(10):1153-6.

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Where the market is heading

• Two major themes in the treatment of CRSo topical delivery of medication

“pre-surgical” “post-surgical”

• Chitosan engineered deviceso clinical pathway easier than drug eluting materials

anti-inflammatory anti-bacterial

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CleanWash™ Bottle

• Patented designo PREVENTS BACKWASH CONTAMINATIONo no other bottle on the market provides this feature

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Clincal CasesBefore and after photos

• case 1 - history of multiple sinus surgeries prior to seeing me. I recommended hydrodebridement about a year ago. She presented again with diffuse infection. Started a regimen of topical abx with ChitoRhino. No oral abx

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Clinical Cases

• case 2 - my own patient. I performed an MMA for persistent CRS. Despite the procedure and nearly 8 months of topical and oral abx, he had persistent infection. I repeated topical antibiotics with ChitoRhino with another round of oral abx and steroids.

Ideoto, LLC

Ideoto, LLC

Ideoto, LLC

Ideoto, LLC

Ideoto, LLC

Opportunity

• Factso LARGE CRS marketo Only one other branded saline rinse common in ENT*o ChitoRhino™ and the CleanWash™ bottle are UNIQUE

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OpportunityThe two converging forces in rhinology right now are

topical drug delivery and the exploitation of the

natural benefits of chitosan.

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OpportunityAll major medical device companies in the world with

a focus on ENT have released, distribute, or are

working on chitosan based medical devices.• Medtronic• Olympus

Surgeon awareness is growing and will be the underlying driver of grass roots growth.

The literature strongly supports its use – a key component to surgeon recommendation

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Bottom lineThe largest medical device companies in the world have planted a stake in the chitosan frontier.

Ideoto, LLC provides an opportunity to be on the front of the chitosan frontier by driving consumers to the only nasal rinse product line with chitosan.