Effect of Craniosacral Osteopathic Treatment on Chronic Sinusitis: A Randomized Controlled Trial"

Chronic rhinosinusitis (CRS) is a persistent inflammatory condition of the sinonasal mucosa lasting longer than 12 weeks and affecting approximately 10% of the global population. It is characterized by symptoms such as nasal obstruction, mucopurulent discharge, facial pain/pressure, and olfactory dysfunction, all of which significantly impair quality of life. Despite standard medical management-including intranasal corticosteroids, saline irrigation, antihistamines, and antibiotics when indicated-a substantial proportion of patients experience persistent or recurrent symptoms, highlighting the need for complementary and integrative therapeutic approaches.

Osteopathic manipulative treatment (OMT), particularly craniosacral techniques, has been proposed as a therapeutic approach that may influence physiological processes relevant to CRS. These mechanisms include modulation of the autonomic nervous system, enhancement of lymphatic and venous drainage, and improvement of cranial rhythmic impulse and tissue mobility. Through these mechanisms, OMT may facilitate mucociliary clearance and contribute to the reduction of inflammation and symptom burden.

Although preliminary studies have reported beneficial effects of osteopathic and manual therapy interventions in CRS, existing evidence is limited by small sample sizes, lack of adequate control groups, and reliance predominantly on subjective outcome measures. Furthermore, objective assessments such as endoscopic findings and imaging-based evaluations have been insufficiently integrated into prior research.

The present study is designed as a prospective, two-arm, randomized controlled trial to evaluate the effectiveness of craniosacral osteopathic manipulative treatment (OM-KST) as an adjunct to standard medical therapy in individuals with CRS. Eligible participants aged 18-65 years diagnosed with CRS by an otorhinolaryngologist will be randomly assigned to either a control group receiving standard medical treatment or an intervention group receiving OM-KST in addition to medical treatment.

The intervention protocol will consist of eight sessions over a 4-week period (two sessions per week), with each session lasting approximately 45 minutes. The OM-KST protocol will include a structured sequence of techniques focusing on vagal stimulation, lymphatic drainage, and craniosacral regulation.