Acoustic therapy for allergic rhinitis and chronic rhinosinusitis: modulating microbiome, immunity and well-being

Acoustic therapy is reviewed as a non-pharmacological adjunct treatment for allergic rhinitis (AR) and chronic rhinosinusitis (CRS), targeting chronic airway inflammation when standard options often leave patients with persistent symptoms or side effects. The review proposes mechanisms including sound wave-induced vibrations that may increase nitric oxide production, improve mucociliary clearance, activate mechanosensitive immune pathways, and help disrupt pathogenic biofilms. It also links potential effects on the nasal microbiome and downstream immune modulation. Across early clinical trials, acoustic therapy is reported to improve measures such as peak nasal inspiratory flow (about 17% to 31%), reduce nasal congestion and symptom scores (including Total Nasal Symptom Score and SNOT-22), and improve sleep quality and patient-reported outcomes. The authors call for more rigorously designed clinical trials to assess efficacy, safety, and long-term impact.