Efficacy of Cryoablation on Chronic Rhinitis Management: A Systematic Review and Meta-Analysis

Abstract

Background ClariFix for posterior nasal nerve ablation has been approved for use since 2017, and this is the first study attempting to synthesize and assess the efficacy of this new device on the management of chronic rhinitis. Objective The primary objective of this meta-analysis is to assess the efficacy of ClariFix in the symptomatic management of patients with chronic rhinitis. The main outcome measure is the mean difference in the reflective total nasal symptom score (rTNSS). Methods A systematic search of Pubmed/Medline, Web of Science, and EBSCOhost was conducted from inception to May 2022. Peer-reviewed clinical trials reporting postcryotherapy rTNSS at both 1- and 3-month intervals for patients with chronic rhinitis were included. A random-effects model was utilized for meta-analysis. Study heterogeneity, bias, and overall quality were all assessed. The authors followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. The primary outcome measures included mean differences in rTNSS from baseline to both 1- and 3-month postoperative time points. Secondary measures included other questionnaires including the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ). Results There were 5 studies that met the criteria (247 individuals). The pooled rTNSS mean difference from baseline to 1 and 3 months postoperatively was found to be −3.48 points (95% CI: −3.73 to −3.23, I2 = 0.13). and −3.50 (95% CI: −3.71 to −3.29, I2 = 0.00), respectively. The mean difference from baseline to 3 months postoperatively regarding the RQLQ was found to be −1.53 (95% CI: −1.74 to −1.31, I2 = 0.00). The most common adverse effects included facial or surgical site pain (40.4%), followed by headache (18.2%), oral numbness (11.1%), and sinusitis (4.0%). Conclusions The findings of this systematic review suggest that cryoablation with Clarifix is an effective treatment modality for chronic rhinitis. However, higher-quality randomized controlled trials will need to be performed to affirm the findings of this study.

Long‐term outcomes following impedance‐controlled radiofrequency ablation for the treatment of chronic rhinitis

“…The total rTNSS improved from baseline to all time points and the responder rate was 80% at 12 months. These findings are consistent with findings of our device and other devices for rhinitis 4,15,16 . Confirming chronic rhinitis specific quality of life improvement, the total mini RQLQ score and all 5 domains significantly improved over baseline and the 12‐month MCID rate was 86%.…”

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

“…However, “chronic rhinitis”, a previously reported indication, is an ambiguous definition. Two reviews were reported, but neither provided a clear definition of chronic rhinitis, and all included articles with various rhinitis evaluation criteria 25,26 . Young et al 26 provided data up to 3 months after treatment.…”

“…Two reviews were reported, but neither provided a clear definition of chronic rhinitis, and all included articles with various rhinitis evaluation criteria 25,26 . Young et al 26 provided data up to 3 months after treatment. Pooled rTNSS MD from baseline to 1 and 3 months postoperatively was found to be −3.48 points (95% CI: −3.73 to−3.23 and −3.50 [95%] CI: −3.71 to −3.29), respectively.…”

“…Therefore, analysis focusing on NAR treatment is an important factor in considering future treatment options. Also, previous studies were limited to systematic review 25 or effect analysis within 3 months after surgery, 26 but this study was able to analyze long‐term effects up to 12 months. Through this study, it was confirmed that long‐term effects were more pronounced in the NAR group than in the AR group, and that it was particularly effective for rhinorrhea and congestion symptoms.…”

This Summer, Think Like a Vagabond

“…Cryoablation of the posterior nasal nerve to treat chronic rhinitis became more available in 2017 following the introduction of the Clarifix device which offered an alternative to more traditional surgical treatments such as vidian neurectomy. Young et al 3 present a systematic review and meta-analysis examine the efficacy of cryoablation for chronic rhinitis and suggest that their findings indicate that it is an effective treatment modality for the ailment.…”