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Therapeutic ultrasound as treatment for chronic rhinosinusitis: preliminary observations

Published online by Cambridge University Press:  06 January 2010

D Young ,
R Morton  and
J Bartley
D Young
Affiliation:
Division of Otolaryngology-Head and Neck Surgery, Counties-Manukau District Health Board, Auckland, and the Department of Surgery, South Auckland Clinical School, University of Auckland, New Zealand
R Morton
Affiliation:
Division of Otolaryngology-Head and Neck Surgery, Counties-Manukau District Health Board, Auckland, and the Department of Surgery, South Auckland Clinical School, University of Auckland, New Zealand
J Bartley*
Affiliation:
Division of Otolaryngology-Head and Neck Surgery, Counties-Manukau District Health Board, Auckland, and the Department of Surgery, South Auckland Clinical School, University of Auckland, New Zealand
*
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
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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.

Keywords

SinusitisUltrasound TherapyBacterial Biofilms

Information

Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 124 , Issue 5 , May 2010 , pp. 495 - 499
Copyright
Copyright © JLO (1984) Limited 2009

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