Therapeutic ultrasound as treatment for chronic rhinosinusitis: preliminary observations

J Laryngol Otol. 2010 May;124(5):495-9. doi: 10.1017/S0022215109992519. Epub 2010 Jan 6.

Abstract

Background: Bacterial biofilms have been implicated in the pathogenesis of chronic rhinosinusitis. In the laboratory setting, ultrasound is effective in disrupting such biofilms; however, few clinical studies have evaluated the role of therapeutic ultrasound in chronic rhinosinusitis.

Objective: This study was performed to investigate the short-term effectiveness of therapeutic ultrasound as a treatment modality for chronic rhinosinusitis.

Methods: Twenty-two patients with a positive history of chronic rhinosinusitis, according to the criteria set out by the Rhinosinusitis Task Force, together with a previous computed tomography scan compatible with a diagnosis of chronic rhinosinusitis, and who had failed previous, aggressive medical management, were treated with therapeutic pulsed ultrasound at 1 MHz two to three days per week for six sessions. Patients completed an assessment of individual sinus symptom severity and the 20-Item Sino-Nasal Outcome Test questionnaire before treatment, prior to session four and after completion of session six.

Results: Two patients were unable to complete the study protocol. After completion of session six, 18 patients had experienced improvement in symptoms, while two patients noted a worsening of symptoms. Median percentage improvement of the total overall symptom score was 16.7 per cent (Wilcoxon signed rank, p < 0.001). The 20-Item Sino-Nasal Outcome Test score improved by 34.1 per cent (Wilcoxon signed rank, p < 0.0001).

Conclusion: This study demonstrated a significant improvement in chronic rhinosinusitis symptoms after a six-session course of pulsed ultrasound therapy. Treatment with ultrasound alone or combined with antibiotics may provide a strategy to target biofilms on the sinus mucosa. Therapeutic ultrasound warrants further investigation as a potential treatment modality for chronic rhinosinusitis.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Biofilms
  • Chronic Disease
  • Combined Modality Therapy
  • Female
  • Humans
  • Male
  • Middle Aged
  • Rhinitis / diagnostic imaging
  • Rhinitis / therapy*
  • Severity of Illness Index
  • Sinusitis / diagnostic imaging
  • Sinusitis / therapy*
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Ultrasonic Therapy / methods*
  • Young Adult

Substances

  • Anti-Bacterial Agents