Skip to main content
×
Home
    • Aa
    • Aa

Therapeutic ultrasound as treatment for chronic rhinosinusitis: preliminary observations

  • D Young (a1), R Morton (a1) and J Bartley (a1)
Abstract
AbstractBackground:

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.

Copyright
Corresponding author
Address for correspondence: Mr Jim Bartley, Otolaryngologist, 10 Owens Rd, Epsom, Auckland 1023, New Zealand. Fax: +649 631 0478 E-mail: jbartley@ihug.co.nz
References
Hide All
1Benninger MS, Ferguson BJ, Hadley JA, Hamilos DL, Jacobs M, Kennedy DW et al. Adult chronic rhinosinusitis: definitions, diagnosis, epidemiology, and pathophysiology. Otolaryngol Head Neck Surg 2003;129(Suppl. 3):S132
2Kilty SJ, Desrosiers MY. The role of bacterial biofilms and the pathophysiology of chronic rhinosinusitis. Curr Allergy Asthma Rep 2008;8:227–33
3Hunsaker DH, Leid JG. The relationship of biofilms to chronic rhinosinusitis. Curr Opin Otolaryngol Head Neck Surg 2008;16:237–41
4Post JC, Hiller NL, Nistico L, Stoodley P, Ehrlich GD. The role of biofilms in otolaryngologic infections: update 2007. Curr Opin Otolaryngol Head Neck Surg 2007;15:347–51
5Psaltis AJ, Wietzel EK, Ha KR, Wormald P-J. The effect of bacterial biofilms on post-sinus surgical outcomes. Am J Rhinol 2008;22:16
6Bartley J, Young D. Ultrasound as a treatment for chronic rhinosinusitis. Med Hypotheses 2009;73:1517
7Le T, Psaltis A, Tan LW, Wormald PJ. The efficacy of topical antibiofilm agents in a sheep model of rhinosinusitis. Am J Rhinol 2008;22:560–7
8Chiu AG, Palmer JN, Woodworth BA, Doghramji L, Cohen MB, Prince A et al. Baby shampoo nasal irrigations for the symptomatic post-functional endoscopic sinus surgery patient. Am J Rhinol 2008;22:34–7
9Kahn J. Principles and Practice of Electrotherapy. New York: Churchill Livingstone, 2000
10Ansari NN, Naghdi S, Farhadi M, Jalaie S. A preliminary study into the effect of low-intensity pulsed ultrasound on chronic maxillary and frontal sinusitis. Physiother Theory Pract 2007;23:211–18
11Ansari NN, Naghdi S, Farhadi M. Physiotherapy for chronic rhinosinusitis: the use of continuous ultrasound. Int J Ther Rehabil 2007;14:306–10
12Naghdi S, Ansari NN, Farhadi M. A clinical trial on the treatment of chronic rhinosinusitis with continuous ultrasound. J Phys Ther Sci 2008;20:233–8
13Piccirillo JF, Merritt MG Jr, Richards ML. Psychometric and clinimetric validity of the 20-Item Sino-Nasal Outcome Test (SNOT-20). Otolaryngol Head Neck Surg 2002;126:41–7
14Lund VJ, Kennedy DW. Staging for rhinosinusitis. Otolaryngol Head Neck Surg 1997;117:S3540
15Jonsson P, Sahlstrand-Johnson P, Holmer NG, Persson HW, Jannert M, Jansson T et al. Feasibility of measuring acoustic streaming for improved diagnosis of rhinosinusitis. Ultrasound Med 2008;34:228–38
16Heges MM, Lewis J, Lunec J, Cramp WA. The effect of ultrasound at 1.5 MHz on Escherichia coli. Int J Radiat Biol 1980;37:103–8
17Scherba G, Weigel RM, O'Brien WD. Quantitative assessment of the germicidal efficacy of ultrasonic energy. Appl Environ Microbiol 1991;57:2079–84
18Quian Z, Sagers RD, Pitt WG. The effect of ultrasonic frequency upon enhanced killing of P. aeruginosa biofilms. Ann Biomed Eng 1997;25:6976
19Geerlings SE, Hoelepman AI. Immune dysfunction in patients with diabetes mellitus (DM). FEMS Immunol Med Microbiol 1999;26:259–65
20Pitt WG, Ross SA. Ultrasound increases the rate of bacterial cell growth. Biotechnol Prog 2003;19:1038–44
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

The Journal of Laryngology & Otology
  • ISSN: 0022-2151
  • EISSN: 1748-5460
  • URL: /core/journals/journal-of-laryngology-and-otology
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords:

Metrics

Full text views

Total number of HTML views: 1
Total number of PDF views: 14 *
Loading metrics...

Abstract views

Total abstract views: 211 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 22nd October 2017. This data will be updated every 24 hours.