Patient-specific, GPU-accelerated CFD simulations, increasingly refined by AI, will enable predictive deposition mapping and integration with PBPK models. This supports in silico trials and personalized device optimization, yet clinical translation is limited by validation gaps, regulatory conservatism, and manufacturing complexities. Future integration of real-time imaging, AI surrogates, and smart delivery systems may shift nasal drug delivery toward per-nostril precision medicine and virtual-cohort-based regulatory acceptance.