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

Michael Smith,Philippe Berenger,Peter Bonutti,Justin Beyers,Vivek Ramakrishnan,Alisa Ramakrishnan

doi:10.3390/sinusitis2030005

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.

Highlights

Chronic rhinosinusitis (CRS) is one of the most common conditions in North America, with almost40 million patients [1]
Symptoms of nasal congestion and facial pain significantly reduce the quality of life of CRS patients [3,4]
Chronic rhinosinusitis is characterized by the long-term presence of multiple symptoms including mucopurulent drainage and nasal congestion, and about 80% of CRS patients report facial pain/pressure [4,6,7]

Summary

Introduction

Chronic rhinosinusitis (CRS) is one of the most common conditions in North America, with almost40 million patients [1]. Chronic rhinosinusitis (CRS) is one of the most common conditions in North America, with almost. Symptoms of nasal congestion and facial pain significantly reduce the quality of life of CRS patients [3,4]. Application of high frequency vibration to sinus regions in CRS patients has been shown to reduce pain and associated symptoms [5]. Chronic rhinosinusitis is characterized by the long-term presence of multiple symptoms including mucopurulent drainage and nasal congestion, and about 80% of CRS patients report facial pain/pressure [4,6,7]. Factors contributing to the pathophysiology of adult CRS include allergies, bacterial biofilms, asthma and exposure to various environmental pollutants [2,7,8,9]. Radiography or computed tomography (CT) scans are often used to identify mucosal thickening and to identify any comorbid factors such as anatomic abnormalities

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