Cryosurgical ablation for treatment of rhinitis: A prospective multicenter study. (30th September 2019)

• Record Type: Journal Article
• Authors: Chang, Michael T.; Song, Sunhee; Hwang, Peter H.
• Is Part Of: Laryngoscope. Volume 130:Number 8(2020)
• Page Start: 1877
• Page End: 1884
• Publication Date: 2019-09-30
• Subjects: Rhinitis -- cryosurgery -- cryoablation -- rhinorrhea -- congestion -- posterior nasal nerve; Otolaryngology -- Periodicals; 617.51005
• DOI: 10.1002/lary.28301
• Languages: English
• ISSNs: 0023-852X

Abstract

Abstract : Objective: To assess the efficacy and safety of cryoablation of the posterior nasal nerve (PNN) for treatment of chronic rhinitis. Methods: This was a prospective single‐arm trial of 98 adult patients at six U.S. centers with chronic allergic and nonallergic rhinitis. PNN cryoablation was performed in‐office under local anesthesia using a handheld device. Patients discontinued use of intranasal ipratropium 3 days prior to treatment and throughout the study period. Reflective Total Nasal Symptom Score (rTNSS) was measured at pretreatment baseline and posttreatment at 1 month, 3 months, 6 months, and 9 months. The Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) was completed at pretreatment and 3 months posttreatment. Adverse effects and postprocedure medication usage were recorded. Results: Ninety‐eight procedures (100%) were successfully completed. rTNSS significantly improved over pretreatment baseline (6.1 ± 1.9) at 1 month (2.9 ± 1.9, P < 0.001), 3 months (3.0 ± 2.3, P < 0.001), 6 months (3.0 ± 2.1, P < 0.001), and 9 months (3.0 ± 2.4, P < 0.001) postprocedure. Nasal congestion and rhinorrhea subscores improved significantly at all time points ( P < 0.001). Both allergic and nonallergic rhinitis subcohorts showed improvement ( P < 0.001), with a comparable degree of improvement between groups. RQLQ significantly improved over pretreatment baseline (3.0 ± 1.0) at 3 months (1.5 ± 1.0, P < 0.001), and all RQLQ subdomains demonstrated improvement. Of 54 patients using intranasal medication at baseline, 19 (35.2%) were able to discontinue use. Twenty‐nine adverse effects were reported, including headache, epistaxis, and sinusitis. Conclusion: Cryoablation of the PNN for chronic rhinitis is safe and can result in relief of nasal symptoms and improvements in quality of life. Level of Evidence: 4 Laryngoscope, 130: 1877–1884, 2020