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

BACKGROUND: Acoustic energy and vibration therapy are emerging as helpful adjuncts among many disease states. There has been interest in how this technology can either serve as an alternative treatment or enhance delivery of medications to treat pathology within the nasal cavity and paranasal sinuses. Our objective was to perform a scoping review of the state of the science of vibration treatment used in sinonasal disease. METHODS: A search of Embase, PubMed, and CINAHL databases was performed in November 2021. Included studies evaluated acoustic energy as a means of treatment in sinonasal diseases. Data points collected included type of technology utilized, disease state treated, and outcomes. RESULTS: The initial search identified 2902 studies, of which 44 met inclusion criteria. A wide array of vibrational technology such as ultrasound, sonic aerosols, and phonophoresis, with varying frequency and amplitude were described. Twenty‐six studies evaluated the use of acoustic energy to treat sinonasal disease itself, while 18 studies evaluated the use of acoustic energy to facilitate drug delivery to the sinonasal cavity. Outcome measures among studies were highly varied. CONCLUSIONS: Vibration technology used in patients with sinonasal pathology has been shown to improve pain, sinonasal symptoms, and radiologic outcome measures in small studies. Given the heterogeneous study populations and outcomes, no conclusion could be reached regarding overall effectiveness of acoustic energy as a primary treatment. Further research is required to study specific treatment indications in larger patient populations to fully understand the potential clinical benefit and to determine optimal therapeutic characteristics of sound energy.