Clinical Efficacy of Chakrasiddh Nasal Alignment & Sinus Energy Therapy (CNASET) in Chronic Rhinosinusitis (Peenisam): An Observational Study

Abstract

Chronic rhinosinusitis (CRS) is a persistent inflammatory condition of the nasal and paranasal sinus mucosa lasting more than 12 weeks impairing quality of life. Traditional Siddha medicine describes a comparable clinical entity known as Peenisam, attributed primarily to derangement of Vaatham and Iyam. Chakrasiddh Nasal Alignment & Sinus Energy Therapy (CNASET) is a Siddha-based non-invasive therapeutic protocol comprising targeted Varmam (energy point) stimulation over cranial and cervical regions, steam inhalation, and yogic practices aimed at restoring physiological balance, sinus clearance, and neuromuscular regulation. Objective: To evaluate the clinical efficacy and safety of CNASET in patients with chronic rhinosinusitis. Methods: An observational clinical study was conducted on ten patients diagnosed with CRS who underwent four structured CNASET sessions along with ten cervical manual pressure therapy administered over a period of three weeks.  The selected patients were in age bracket 10-20 years and reported to Chakrasiddh Centre between July 2025 and December 2025 with classical symptoms of sinusitis, including nasal obstruction, facial heaviness, headache, postnasal discharge, and associated neck pain. Clinical outcomes were assessed using the Sino-Nasal Outcome Test-22 (SNOT-22) and Visual Analog Scale (VAS) for symptom severity. Results: Significant improvement was observed in all patients, with a mean reduction in SNOT-22 score from 47.8±6.4 at baseline to 9.6±3.2 post-treatment. Symptom severity scores for nasal obstruction, facial pain, headache, and cervical discomfort showed marked improvement. No adverse events were reported. Conclusion: CNASET appears to be a safe and effective conservative Siddha intervention for chronic rhinosinusitis. Larger controlled trials are warranted to validate these findings.