Therapeutic ultrasound as a treatment for chronic rhinosinusitis: A systematic review

Objective To investigate the effects of therapeutic ultrasound in symptoms of patients with chronic rhinosinusitis. Data source and study selection Searches were carried out in the MEDLINE (via OVID), SCOPUS, PubMed and Virtual Health Library databases. The study selection is as follows: Pre-experimental and experimental studies in English, Spanish and Portuguese that evaluated the effects of ultrasound on the signs and symptoms of patients with chronic rhinosinusitis were included. After study selection, data extraction, risk of bias and quality assessment, we performed a qualitative description of current data. Results Nine studies were selected, providing 309 participants (20 to 47 volunteers in each study), with an average age of 44.5 years. Three studies had assumed pretest-posttest design, four studies were single-blinded randomized controlled trial and the two studies were double-blinded randomized controlled trial. The modalities of ultrasound investigated were pulsed and continuous, and the studies evaluated the ultrasound effects immediately after one session or after a few sessions of treatment (6, 10 or 15 sessions). The use of ultrasound, in both continuous and pulsed modalities, demonstrated to reduce characteristic signs and symptoms of chronic rhinosinusitis. Despite these results, only two studies had a low risk of bias. A meta-analysis was not possible due to the huge heterogeneity of included studies. Conclusions Despite ultrasound in continuous and pulsed modalities showing similar positive effects in the treatment of chronic rhinosinusitis, the studies are small, short duration, poor design and with a high risk of bias. Thereby, ultrasound cannot be appointed as a potential adjunct resource to current methods of treating chronic rhinosinusitis until large randomised controlled studies are performed.