Chronic rhinosinusitis (CRS) is a chronic infective, inflammatory upper respiratory disease. While the current medical treatment of CRS focuses on the systemic and topical use of steroids and/or antibiotics, many bacteria residing on mucosal surfaces of patients with CRS exist in a biofilm state, making them resistant to most systemic antibiotics. Alternative therapeutic strategies that include blocking bacterial molecular communication, inhibiting biofilm matrix production and breaking down bacterial biofilms are all being explored. Physical therapies such as therapeutic ultrasound (US) have been advocated and utilized as a treatment modality for CRS for many years. US may have antiinflammatory actions and can also be used for the local delivery of drugs through the skin. Therapeutic US, which has been shown in clinical studies to be an effective treatment for both acute rhinosinusitis and CRS, offers significant potential in CRS management.