Multimodal Frequency Treatment for Facial Pain Caused by Chronic Rhinosinusitis: A Pilot Study

Abstract

Chronic rhinosinusitis (CRS) is a common disease that affects over 200 million patients worldwide. CRS often presents with facial pain, which is considered an important criterion for the diagnosis of CRS. A single-arm clinical study was designed to test the effect of simultaneous high (1 MHz) and low frequencies (70-80 Hz) on facial pain in 14 CRS patients at the Sarah Bush Lincoln Health Center, Mattoon, IL, USA. We used two quality of life (QOL) instruments to test the effect of multimodal frequencies on patients suffering from CRS: the Brief Pain Inventory Short Form (BPI-SF), and the Sino-Nasal Outcome Test (SNOT-22). Mean BPI-SF severity scores improved by 0.80 points (Wilcoxon rank sum test p < 0.01) in all 14 patients. In patients with baseline facial pain (n = 9), the scores improved by an average of 1.5 (p < 0.01) points in the pain severity domain and by 1.4 points in the pain interference domain. Additionally, the mean improvement in SNOT-22 scores was 14.11 (p < 0.05), which is above the minimal clinically-important difference (MCID) of nine points. Our pilot study indicates that multimodal vibration frequencies applied over the facial sinuses reduce pain, possibly through the reduction of the inflammatory response and modulation of the pain receptors. This study suggests the possibility that combining different frequencies could have an enhanced effect on reducing CRS-related facial pain.

Resonant vibration of the sinonasal cavities for the treatment of nasal congestion

“…Again, the mechanisms of action are not clear but may be related to vibration-induced modulation of pain receptors or inhibition of the parasympathetic system. 10 As with many pilot studies, there are limitations of this study. First, given that patients were not randomized or blinded, a placebo effect is possible.…”

“…Although we initially chose to measure pain and headache scores to ensure that patients were not experiencing adverse effects of ART, we found that patients not only did not worsen, but also that patients who had some baseline pain and headache (VAS ≥ 1) experienced a notable improvement. Again, the mechanisms of action are not clear but may be related to vibration‐induced modulation of pain receptors or inhibition of the parasympathetic system 10 …”

Applications of vibrational energy in the treatment of sinonasal disease: A scoping review

“…Mean 22‐item Sino‐Nasal Outcome Test (SNOT‐22) improvement over 2 weeks was 14.11 ( p < 0.05), exceeding the minimal clinically important difference (MCID). The authors of this study were associated with the company that developed the AxioSonic device 13 …”