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Abstract:
Objective
Chronic sinusitis (CS) is a very common condition, and may significantly affect a patient’s quality of life. The etiology is typically not clear. Many conservative as well as invasive therapeutic strategies have been suggested, none of them, however, seems close to a golden standard. Osteopathic interventions have repeatedly been considered helpful. This study was designed as a pilot trial to a) test in a semi-quantitative way whether osteopathic interventions may in fact have a therapeutic potential for CS, and b) serve as a feasibility study for a future, rigorous RCT.
Material and methods
Forty-three patients with defined features of CS were recruited by two professional osteopaths and randomized (external randomization) into one of three groups: A) test-dependent osteopathic treatments once weekly, B) daily isotonic saline nasal irrigation, and C) a combination of both. Treatment period was set to 4 weeks with a follow-up 6 weeks thereafter. Main outcome parameters were nasal breathing, headache and tension, and changes in perceived quality of life.
Results
Headache and tension improved most in group A, and remained essentially unchanged in group B. There was a clinically relevant further improvement in group A during follow-up, as opposed to a certain rebound in symptoms in the other two groups. The impact on quality of life was inconsistent.
Conclusions
Osteopathic interventions seem to induce positive changes in the symptomatology of CS with further improvement after cessation of therapy. Most aspects of the study protocol proved feasible, while likert scales used to assess aspects of quality of life should probably be replaced by a more sensitive instrument, taking into account generic as well as condition specific criteria.
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