Jude Oluwapelumi Alao, Jim Bartley, Chris Puli'uvea, David White, Kevin Lee, Kelvin E M Lau
This study provides early longitudinal evidence on acoustic nasal therapy in adults classified as having AR and/or CRS. Patient-reported symptoms improved during active treatment and attenuated after withdrawal, while changes in objective nasal airflow were less consistent. These hypothesis-generating findings support controlled studies to clarify efficacy, optimal dosing, and durability of response.
BACKGROUND AND AIMS: Acoustic nasal therapy has emerged as a potential non-pharmacological adjunct for allergic rhinitis (AR) and chronic rhinosinusitis (CRS), but longitudinal evidence on its effects on nasal airflow and patient-reported outcomes remains limited. This early-phase study evaluated changes in objective nasal airflow and symptom burden following a 4-week acoustic nasal therapy intervention and a follow-up period after treatment withdrawal.
METHODS: A prospective single-arm quasi-experimental longitudinal pilot study was conducted in 30 adults with clinician-diagnosed or symptom-consistent AR and/or CRS. Participants used a bilateral intranasal acoustic device for 10 min twice daily for 4 weeks. Outcomes were assessed at baseline, post-treatment, and follow-up after discontinuation. The primary longitudinal outcomes were peak nasal inspiratory flow (PNIF) and Sino-Nasal Outcome Test-22 (SNOT-22) scores. Secondary variables of subgroup, adherence, correlation, responder, and multivariable analyzes were also explored.
RESULTS: PNIF showed no significant change immediately post-intervention (-2.0 L/min, p = 0.67) but increased between post-treatment and follow-up (+12.2 L/min, p = 0.036); change from baseline to follow-up was not significant (+ 10.1 L/min, p = 0.069 after Holm adjustment). Symptom burden improved significantly during treatment (-15.43 points, p < 0.0001) but partially attenuated after discontinuation (+11.97 points, p = 0.0003), with no significant difference between baseline and follow-up (-3.47 points, p = 0.242). At post-treatment, 66.7% achieved the minimum clinically important difference, decreasing to 33.3% at follow-up. Objective airflow changes did not consistently align with symptom improvement.
CONCLUSION: This study provides early longitudinal evidence on acoustic nasal therapy in adults classified as having AR and/or CRS. Patient-reported symptoms improved during active treatment and attenuated after withdrawal, while changes in objective nasal airflow were less consistent. These hypothesis-generating findings support controlled studies to clarify efficacy, optimal dosing, and durability of response.