Charles Babb BM
Isaac Schmale MD
Li-Xing Man MSc MD MPA
University of Rochester School of Medicine and Dentistry
Educational Objective: At the conclusion of this presentation, the participants should be able to discuss different ayurvedic therapies for the treatment of chronic rhinosinusitis and explain current evidence for their use. Objectives: Chronic rhinosinusitis (CRS) affects 4.5 to 12% of the population and has significant effects on quality of life, productivity, and healthcare costs. Complementary and alternative (CAM) therapies are commonly used to manage CRS. Ayurveda, an ancient medical system that originated on the Indian subcontinent, proposes several treatments for sinus disease. Our goal is to provide a comprehensive systematic review of ayurvedic approaches to the treatment of CRS. Study Design: N/A. Methods: A systematic review utilizing Medline, Embase, and Cochrane Library databases was performed. Articles published prior to August 2017, with at least 10 patients, which investigated ayurveda as the sole or adjunctive treatment for CRS in humans were included. Results: Our search identified 48 unique articles. Six articles met inclusion criteria. Three of these trials were randomized controlled trials (RCTs). Although specific ayurvedic treatments varied, 9 distinct therapies were identified. These include herbal preparations for oral consumption, alternate nasal breathing, steam inhalation, and nasal instillations. These were used alone or in combination with one another. Ayurvedic therapies studied in RCTs and uncontrolled trials show reduction in many CRS symptoms, decrease in radiographic and endoscopic evidence of disease, reduction in peripheral eosinophil count, and improved mucociliary clearance. Conclusions: Ayurvedic management may be useful in treating CRS in some patients. These results must be considered with caution as imprecise criteria for CRS and variable outcome measures were used in each study. Additionally, three trials were uncontrolled. Given these findings as well as a growing interest in CAM, ayurvedic treatments for CRS deserves further investigation.