Acoustic resonance therapy shows promise for pediatric chronic rhinitis

Chronic rhinitis affects up to 40% of children and adolescents and is frequently associated with persistent nasal congestion, sleep disruption, impaired concentration, and reduced quality of life.¹ Although intranasal corticosteroids and antihistamines remain mainstays of treatment, long-term symptom control often depends on consistent adherence—an ongoing challenge, particularly among adolescents. As interest grows in nonpharmacologic approaches to managing chronic upper airway symptoms, investigators are exploring new technologies that may offer symptom relief without the burden of daily medication use.

A recent feasibility study published in OTO Open evaluated acoustic resonance therapy (ART) in 31 patients aged 12 to 21 years with chronic rhinitis and moderate-to-severe nasal congestion.² After 2 weeks of treatment with a smartphone-connected wearable device that delivers individualized acoustic vibratory energy to the sinonasal cavities, participants experienced significant improvements in nasal congestion and overall symptom burden. The study found a 35.2% reduction in nasal congestion scores and a 40.5% reduction in Total Nasal Symptom Scores, with no adverse events reported. Additionally, more than 93% of participants reported improvement in congestion symptoms, and adherence to the twice-daily treatment regimen exceeded 85%.

In this Q&A, Contemporary Pediatrics spoke with SoundHealth founder and CEO Paramesh Gopi, PhD, about the rationale behind acoustic resonance therapy, the study's key findings, how the technology is designed to work, and what additional evidence may be needed as pediatricians consider emerging nonpharmacologic options for children and adolescents with chronic rhinitis.

Contemporary Pediatrics: What unmet needs in pediatric chronic rhinitis management led your team to investigate acoustic resonance therapy as a nonpharmacologic treatment option?

Paramesh Gopi, PhD: Up to 40% of children suffer from nasal congestion associated with chronic rhinitis, which severely impacts their overall quality of life.¹ While medicated nasal sprays are standard care, our team looked toward a nonpharmacologic option like Acoustic Resonance Therapy (ART) due to 2 major clinical hurdles:

1. Poor medication adherence: Traditional rhinitis therapies heavily rely on daily compliance, which is notoriously difficult to maintain in adolescents. SONU can be utilized while kids are doing their homework, watching TV, or playing sports. It can be utilized as needed to treat nasal congestion or used prophylactically to prevent episodes. (See additional details in response to number 4).
2. Drug side effects: Families and pediatricians frequently seek alternatives to avoid the localized or systemic side effects tied to long-term pharmacotherapy (such as intranasal corticosteroids or antihistamines).

Contemporary Pediatrics: The study demonstrated significant improvements in nasal congestion and overall Total Nasal Symptom Score after 2 weeks of treatment. Which findings were most clinically meaningful to you, particularly for pediatric patients?

Gopi: The most meaningful takeaway is that 93.5% of pediatric subjects reported improvement in nasal congestion, and 96.8% reported an improvement in overall symptoms, without a single adverse event.

From a strict clinical benchmark perspective:

• Beating the MCID: The minimal clinically important difference (MCID) for the Total Nasal Symptom Score (TNSS) is a change of 0.28. Our study demonstrated an aggregate TNSS reduction of -2.74, an average symptom reduction of 40.5% that vastly exceeds the clinical significance threshold.
• Comparable to medication: The overall 35.2% reduction in the nasal congestion sub-score matches the historical effect sizes seen with intranasal corticosteroids in randomized controlled trials.
• Broad spectrum relief: While designed to target congestion, post-hoc analysis showed statistically significant drops across all secondary symptoms: sneezing (-43.7%), nasal itching (-45.8%), and rhinorrhea (-40.2%).

Contemporary Pediatrics: Can you explain how the acoustic resonance therapy device works and what pediatricians should understand about the proposed mechanism behind symptom improvement?

Gopi: The device used in the study is the SONU band (SoundHealth), a smartphone-integrated headband that delivers customized, calibrated acoustic vibratory energy directly to the sinonasal cavities via bone conduction transducers.

Pediatricians should understand that this is not a generic "one-size-fits-all" vibration. The mechanism relies on personal anatomy and local physics:

• AI-driven calibration: The patient uses a smartphone app to scan their face. A machine-learning model (built on CT scan algorithms) uses these facial landmarks to estimate the patient's exact sinonasal volume and calculate its unique resonant frequency.
• Physiological impact: By humming at this precise resonant frequency, the sound waves create mechanical vibration in the nasal passages. This acoustic energy triggers three major local responses:

1. Vasoconstriction: Promotes structural decongestion of swollen nasal mucosa.
2. Mucociliary clearance: Stimulates the microscopic cilia to beat more effectively.
3. Reduced viscosity: Mechanically thins out thick mucus, making it easier to clear.
4. Neuromodulation: Believed to influence sympathetic tone and increase local exhaled nitric oxide.

Contemporary Pediatrics: Adherence can be a challenge with traditional rhinitis therapies in adolescents. Based on your study experience, how feasible and acceptable was this treatment approach for patients and families?

Gopi: Adherence was highly encouraging. Over the course of the 2-week study, overall adherence to the twice-daily, 15-minute sessions was 85.9% (with 373 out of 434 total treatments successfully completed). This suggests that a smartphone-enabled wearable device is a highly feasible, acceptable, and low-friction treatment model for modern adolescents and their families.

Contemporary Pediatrics: Because this was a feasibility study without a sham-control arm, what are the next research steps needed before acoustic resonance therapy could be more broadly considered in pediatric rhinitis care?

Gopi: Because the original adult FDA indication was already supported by a multi-center, randomized, double-blinded, sham-controlled trial, which rigorously validated Acoustic Resonance Therapy (ART) against a physically identical, non-therapeutic 2 kHz acoustic headband, a pediatric sham-controlled arm was not required. Instead, to avoid unnecessary or unethical testing on children, the FDA allows for the extrapolation of adult clinical data, as the symptoms of rhinitis and SONU’s effects are highly similar. Consequently, SONU is being broadly adopted by pediatricians, parents, and children to date.

References

1. Chrysouli K, Theodorakopoulos C, Saratsiotis A, Kakosimou C, Tsami C, Vrettakos P, Kokolakis G, Gounari A. Allergic Rhinitis in Children: An Underestimated Disease. Indian J Otolaryngol Head Neck Surg. 2024 Apr;76(2):1759-1764. doi: 10.1007/s12070-023-04402-z. Epub 2023 Dec 13. PMID: 38566743; PMCID: PMC10982218.

2. Khanwalkar AR, Greene A, Ma Y, Gopi P, Mohan V, Lin B, Hwang PH. Acoustic vibrational therapy for the treatment of pediatric rhinitis. OTO Open. 2026;10(2):e70247. doi:10.1002/oto2.70247.