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Acoustic Resonance Therapy Safe for Rhinitis-related Nasal Congestion - Mass General Advances in Motion

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Bleier, MD, FACS, of Mass Eye and Ear, and colleagues found in a two-week randomized trial that acoustic resonance therapy was significantly more effective than sham therapy for moderate.." > <title>Acoustic Resonance Therapy Safe for Rhinitis-related Nasal Congestion - Mass General Advances in Motion</title> <link rel="canonical" href="https://advances.massgeneral.org/otolaryngology/journal.aspx?id=2586"> <meta name="specialty-detail" content="Otolaryngology|/otolaryngology/specialty.aspx?id=1016"> <meta name="specialty" content="Otolaryngology"> <meta name="pubDate" content="February 14, 2024"> <meta name="hubContentType" content="Journal"> <meta property="og:locale" content="en_US"> <meta property="og:url" content="https://advances.massgeneral.org/otolaryngology/journal.aspx?id=2586"> <meta property="og:site_name" content="Mass General Advances in Motion"> <meta property="og:title" content="Acoustic Resonance Therapy Safe for Rhinitis-related Nasal Congestion"> <meta property="og:description" content="Benjamin S. 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for?</span> <span class="nav-search__label--mobile">Search</span> </label> <input type="search" id="site-search" value=""> <button class="fat-button"><span class="a11y-sr-only">Submit</span></button> </p> </div> </li> </ul> </nav> </header> <!--googleon: all--> <!-- /global header--> <!-- content wrapper --> <main class="site-main" id="main-content" tabindex="-1"> <div id="panelMainContent"> <article dcrname ="iwDCR0_051320"> <header class="-padding--horizontal" itemscope itemtype="http://schema.org/ScholarlyArticle"> <div class="content-header content-container -width--wide -centered"> <div class="tags"> <ul class="tag__list"> <li class="tag__item"> <a class="tag__link" href="/otolaryngology/specialty.aspx?id=1016">Otolaryngology</a> </li> </ul> </div> <h1 class="content-header__heading" itemprop="name">Acoustic Resonance Therapy Safe and Effective for Nasal Congestion in Rhinitis</h1> <div class="content-header__metadata"> <p class="content-metadata"> <span class="content-metadata__media -journal">Journal</span> <time class="date" datetime="2024-02-14" itemprop="datePublished">Published on February 14, 2024 </time> </p> <p data-module="share-links"> </p> <p class="citation"> Originally published on <cite itemprop="citation"><a href="https://onlinelibrary.wiley.com/doi/10.1002/alr.23284">International Forum of Allergy & Rhinology</a></cite> </p> </div> </div> </header> <div class="-padding--vertical -padding--horizontal"> <div class="layout-columns -width--wide -centered"> <div class="layout-columns__main"> <div class="layout-columns__main__content"> <div class="content-summary"> <h3 class="content-summary__heading">Key findings</h3> <ul> <li>This randomized, sham-controlled, double-blind two-week trial evaluated the safety and efficacy of an investigational proprietary acoustic resonance therapy (ART) in treating nasal congestion in adults with allergic or non-allergic rhinitis</li> <li>Compared with the 26 patients who had sham therapy, the 26 who received ART improved more on the nasal congestion subscore of the Total Nasal Symptom Score (TNSS) (-0.87 vs. -0.44 point; P=0.008) and the overall TNSS (-2.85 vs. -1.32 points; P=0.027)</li> <li>Response rates were higher in the ART group than the control group for the nasal congestion subscore (81% vs. 46%; P=0.02) and the overall TNSS (85% vs. 65%; P=0.11)</li> <li>No intervention-related severe or non-severe adverse events were noted</li> <li>ART may become an option for patients who prefer a nonpharmacologic approach to rhinitis</li> </ul> </div> <p>A recently developed approach to treating nasal decongestion is to apply acoustic energy or vibration to the sinonasal cavities. Acoustic resonance therapy (ART) improves on this by delivering vibrations at the resonant frequency of each patient's sinonasal cavities, which depends on their anatomy.</p><div class="article__signup-container"> <div class="email-signup-inline__container -background--white"> <style> #email-signup-inline { /* 540px */ background-image: url(/assets/raw/email-signup/cardiovascular-sub-callout.jpg); } @media only screen and (-webkit-min-device-pixel-ratio: 2), only screen and (min--moz-device-pixel-ratio: 2), only screen and (-moz-min-device-pixel-ratio: 2), only screen and (-o-min-device-pixel-ratio: 2/1), only screen and (min-device-pixel-ratio: 2), only screen and (min-resolution: 192dpi), only screen and (min-resolution: 2dppx) { #email-signup-inline { /* 1080 width */ background-image: url(/assets/raw/email-signup/cardiovascular-sub-callout.jpg); } } </style> <div class="content-container -width--wide -centered email-signup-inline__wrapper" id="email-signup-inline"> <div class="email-signup-inline__logo"> <img alt="Massachusetts General Hospital building" src="/assets/logos/logo-white.svg"> </div> </div> <div class="email-signup-inline"> <h3 class="email-signup-inline__heading">Subscribe to the latest updates from Otolaryngology Advances in Motion</h3> <p class="email-signup-inline__subheading"></p> <!-- FORM: HEAD SECTION --> <meta http-equiv="Content-Type" content="text/html; 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Rhinology</em></a><em>.</em><span>&nbsp;</span>Now, a randomized trial has produced further evidence of the safety and effectiveness of ART for nasal congestion.</p> <p><a title="Research contributions by Benjamin S. Bleier, MD, FACS" href="https://advances.massgeneral.org/contributors/contributor.aspx?id=1614">Benjamin S. Bleier, MD, FACS</a>, director of otolaryngology translational research at&nbsp;<a title="Mass Eye and Ear" href="https://www.masseyeandear.org/" target="_blank" rel="noopener noreferrer">Mass Eye and Ear</a>, and colleagues detail the findings in a new paper published in the&nbsp;<em><a title="Acoustic resonance therapy is safe and effective for the treatment of nasal congestion in rhinitis: A randomized sham-controlled trial" href="https://onlinelibrary.wiley.com/doi/10.1002/alr.23284" target="_blank" rel="noopener noreferrer">International Forum of Allergy &amp; Rhinology</a>.</em></p> <h2>Background on Sonu</h2> <p>Sonu delivers ART through a headband worn around the forehead that houses two bone conduction transducers. The headband has a Bluetooth connection to a smartphone app that uses the smartphone's camera to capture multiple surface anatomic landmarks.</p> <p>An algorithm calculates the volumes of the maxillary sinus, ethmoid sinus, and nasal cavity (sphenoid and frontal sinuses excluded). It delivers the appropriate resonant frequency for the individual, which falls in the audible range of 100 to 1,000 Hz.</p> <h2>Methods</h2> <p>Conducted at three centers, the two-week trial enrolled 52 subjects (58% female, mean age 47, age range 18&ndash;72) who reported having symptoms of moderate to severe nasal congestion for at least one month secondary to allergic or non-allergic rhinitis. At screening they had a 24-hour reflective nasal congestion subscore &ge;2 on the Total Nasal Symptoms Score (TNSS).</p> <p>Participants were randomly assigned 1:1 in a double-blinded fashion to use one of the following for 15 minutes twice daily for two weeks:</p> <ul> <li>ART&mdash;Continual sound transmission of the individually calculated resonant frequency and associated harmonics through the Sonu device</li> <li>Sham therapy&mdash;A physically identical device delivered a non-resonant acoustic tone (2 kHz) at 50% volume for&nbsp;two seconds, followed by eight seconds of silence; the frequency fell outside the highest resonant range of the treatment group but could still be felt and heard</li> </ul> <p>Each participant received $125.</p> <h2>Primary&nbsp;and Secondary&nbsp;Endpoints</h2> <p>The primary and secondary endpoints were improvement from baseline in the TNSS nasal congestion subscore and the overall TNSS, respectively, averaged over the two weeks of treatment:</p> <ul> <li>TNSS nasal congestion subscore: &minus;0.87 point with ART vs. &minus;0.44 point with sham therapy (P=0.008)</li> <li>Overall TNSS: &minus;2.85 vs. &minus;1.32 points (P=0.027)</li> </ul> <p>The differences remained significant after adjustment for age, gender, and allergic versus nonallergic rhinitis. Moreover, the nasal congestion subscore and the overall score were better in week&nbsp;two of treatment than in week one.</p> <h2>Other Findings</h2> <p>The response rate was defined as the proportion of participants who reported improvement greater than the minimal clinically important difference (MCID) of 0.23 point:</p> <ul> <li>TNSS nasal congestion subscore: 81% with ART vs. 46% with sham therapy (P=0.02)</li> <li>Overall TNSS: 85% vs. 65% (P=0.11)</li> </ul> <p>Even after adjustment for demographics and allergic/non-allergic rhinitis, the probability of achieving or exceeding the MCID was greater with ART than sham therapy:</p> <ul> <li>TNSS nasal congestion subscore: RR, 1.75; P=0.016</li> <li>Overall TNSS: RR, 1.51; P=0.011</li> </ul> <p>No intervention-related severe or non-severe adverse events were noted.</p> <h2>Commentary</h2> <p>The effect size for ART in this study compared favorably with that of intranasal corticosteroid sprays in randomized placebo-controlled trials for allergic rhinitis. ART may be an attractive option for patients with rhinitis who wish to avoid the risk of rhinitis medicamentosa or cardiovascular side effects with decongestants or are bothered by dryness, epistaxis or bad taste with nasal steroids.</p> <p>The trial was sponsored by Sound Health Systems, which anticipates that future research into ART may include indications such as chronic rhinosinusitis and upper airway resistance syndrome.</p> <figure class="stat" data-plaintext="81% response rate to acoustic resonance therapy in patients with nasal congestion related to rhinitis" data-module="stat"><span class="stat__number"><span data-stat-number="">81</span>%</span> <figcaption class="stat__caption">response rate to acoustic resonance therapy in patients with nasal congestion related to rhinitis</figcaption> <p data-module="share-links"></p> </figure> <figure class="stat" data-plaintext="2.85-point average reduction in the Total Nasal Symptom Score over two weeks in patients with nasal congestion related to rhinitis who received acoustic resonance therapy" data-module="stat"><span class="stat__number"><span data-stat-number="">2.85</span></span> <figcaption class="stat__caption">point average reduction in the Total Nasal Symptom Score over two weeks in patients with nasal congestion related to rhinitis who received acoustic resonance therapy</figcaption> <p data-module="share-links"></p> </figure> <figure class="stat" data-plaintext="75% greater probability of responding to acoustic resonance therapy than sham therapy among patients with nasal congestion related to rhinitis" data-module="stat"><span class="stat__number"><span data-stat-number="">75</span>%</span> <figcaption class="stat__caption">greater probability of responding to acoustic resonance therapy than sham therapy among patients with nasal congestion related to rhinitis</figcaption> <p data-module="share-links"></p> </figure><p class="fat-link__wrapper u-text-right"> <a class="fat-link -caret -large" href="https://onlinelibrary.wiley.com/doi/10.1002/alr.23284">view original journal article <em>Subscription may be required</em></a> </p> <div class="article-attribution" itemscope itemtype="http://schema.org/ScholarlyArticle"> <p class="article-attribution__logo" itemscope itemtype="http://schema.org/Periodical"> <a href="https://onlinelibrary.wiley.com/doi/10.1002/alr.23284"> <span class="a11y-sr-only" itemprop="name">International Forum of Allergy & Rhinology</span> </a> </p> <p class="article-attribution__metadata" itemscope itemtype="http://schema.org/PublicationIssue"> <span> Journal Article Published: <time datetime="2023-10-09" itemprop="datePublished">October 9, 2023</time> </span> </p> </div> <p class="cta">Learn more about the <a href="https://masseyeandear.org/otolaryngology">Department of Otolaryngology–Head and Neck Surgery at Mass Eye and Ear</a></p> <p class="cta">Refer a patient to <a href="https://masseyeandear.org/medical-professionals/refer-a-patient">Mass Eye and Ear/Mass General Brigham</a></p> </div> </div> <aside class="layout-columns__sidebar -article__contributors"> <div class="layout-columns__sidebar__content"> <div class="profile-compact__wrapper"> <p class="u-no-margin"> <strong>Contributors</strong> </p> <div class="profile -compact" itemscope itemtype="http://schema.org/Person"> <div class="profile__content"> <h3 class="profile__name" itemprop="name"> <a href="/contributors/contributor.aspx?id=1614" itemprop="url">Benjamin S. Bleier, MD, FACS&nbsp;›</a></h3><p class="profile__title" itemprop="jobTitle">Director, Endoscopic Skull Base Surgery, Mass Eye and Ear, Claire and John Bertucci Chair in Otolaryngology, Associate Professor of Otolaryngology–Head and Neck Surgery, Harvard Medical School</p> </div> <p class="profile__image"> <img alt="" itemprop="image" srcset="/assets/images/contributors/ben_bleier_advances.png, /assets/images/contributors/ben_bleier_advances_2x.png 2x" src="/assets/images/contributors/ben_bleier_advances.png"> </p> </div> </div> </div> </aside> <section class="-padding--horizontal -padding--vertical -article__related"> <div class="layout-columns -width--wide -centered"> <div class="layout-columns__pod--half"> <div class="content-tease" itemscope itemtype="http://schema.org/ScholarlyArticle"> <p class="content-tease__topic"> <span class="highlight">Related</span> </p> <h3 class="content-tease__heading" itemprop="name"> <a href="/otolaryngology/article.aspx?id=1533" itemprop="url">A Line of Defense Hidden Inside the Nose</a> </h3> <p itemprop="description"> <p><span>Scientists had long tried to understand why colder temperatures correlate with colds, flus and other upper respiratory viruses. The discovery of an innate immune response at the front of the nose has provided a missing link to the phenomenon.</span></p></p> <p class="content-tease__related"> <a href="/otolaryngology/specialty.aspx?id=1016" itemprop="relatedLink">Otolaryngology</a> </p> <p class="content-metadata"> <span class="content-metadata__media -article">Article</span> <time class="date" datetime="2023-07-04" itemprop="datePublished">July 4, 2023</time> </p> </div> </div> <div class="layout-columns__pod--half"> <div class="content-tease" itemscope itemtype="http://schema.org/ScholarlyArticle"> <p class="content-tease__topic"> <span class="highlight">Related</span> </p> <h3 class="content-tease__heading" itemprop="name"> <a href="/otolaryngology/journal.aspx?id=2305" itemprop="url">Endoscopic Sinus Surgery for Chronic Rhinosinusitis Has Long-term Benefit on Quality of Life</a> </h3> <p itemprop="description"> <p><span>Mass Eye and Ear rhinologists Ralph Metson, MD, and George Scangas, MD, of the Department of Otolaryngology&ndash;Head and Neck Surgery, found that improved quality of life after endoscopic sinus surgery for chronic rhinosinusitis is sustained for at least five years.</span></p></p> <p class="content-tease__related"> <a href="/otolaryngology/specialty.aspx?id=1016" itemprop="relatedLink">Otolaryngology</a> </p> <p class="content-metadata"> <span class="content-metadata__media -journal">Journal</span> <time class="date" datetime="2022-08-29" itemprop="datePublished">August 29, 2022</time> </p> </div> </div> </div> </section> </div> </div> </article> </div> </main> <!--googleoff: all--> <footer class="site-footer"> <div class="-padding--horizontal"> <nav aria-label="Footer links" class="content-container -width--wide -centered -padding--bottom"> <ul class="footer__nav" role="presentation"> <li> <a href="https://www.massgeneral.org/about">About Mass General</a> </li> <li> <a href="https://www.massgeneral.org/about/support">Giving</a> </li> <li> <a 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