Effectiveness of the Posterior Nasal Nerve Cryoablation in Allergic and Non‐Allergic Rhinitis

Abstract

ObjectivesThis study assessed the impact of cryoablation of the posterior nasal nerve on symptoms of rhinitis in individuals with allergic rhinitis (AR) and non‐allergic rhinitis (NAR).Data SourcesPubMed, SCOPUS, Embase, Web of Science, and Cochrane databases for studies published up to June 2023.Review MethodsStudies that evaluated the quality of life and rhinitis‐related symptom scores before and after cryotherapy treatment, as well as sham‐controlled studies, were included.ResultsIn total, 368 patients from seven studies were analyzed. Patients who underwent cryoablation showed a significant improvement in rhinitis‐related symptoms in both NAR and AR. In particular, the most significant improvement was observed in symptoms of rhinorrhea and congestion. Furthermore, cryoablation improved the disease‐specific quality of life evaluated using the Rhinoconjunctivitis Quality of Life Questionnaire. The rate of clinical improvement in the total nasal symptom score (total nasal symptom score [TNSS]; >30% reduction from baseline) after cryotherapy was 74%. The change in TNSS score significantly increased over time in NAR patients (p = 0.0041). Therefore, changes in the TNSS score after 12 months of cryotherapy treatment were greater in the NAR group than in the AR group (p = 0.0020), indicating that cryoablation is effective for both types of rhinitis and has better long‐term efficacy in NAR than in AR.ConclusionsSubjective symptom scores related to rhinitis, particularly for rhinorrhea and congestion, decrease after cryoablation of the posterior nasal nerve. Furthermore, the symptom improvement was greater in NAR than AR. Laryngoscope, 2023

Letter Regarding “Improvement in Nasal Symptoms of Chronic Rhinitis after Cryoablation of the Posterior Nasal Nerve”: Toward a Unified Airway Approach

“…2,3 The use of the above procedure is justified on the basis of nonresponse to standard treatments and the authors state the economic burden of allergic rhinitis, but no reference is made to the cost of the procedure in the introduction. It should also be noted that there is no mention of whether this is a onestage procedure or whether further interventions may be required 4 . Furthermore, it should not be underestimated that cryoablation is an invasive procedure and, although mentioned, it is not without side effects and contraindications.…”