Cryosurgical Ablation for Treatment of Rhinitis: Two-Year Results of a Prospective Multicenter Study

Abstract

Objectives/hypothesis: To assess the long-term (12-24 months) safety and effectiveness of cryoablation of the posterior nasal nerve as treatment for chronic rhinitis.

Study design: A multicenter, prospective, single-arm clinical study.

Methods: The study was conducted from February 2017 to April 2020. Study endpoints included change from baseline in the reflective Total Nasal Symptom Score (rTNSS), Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ), physician assessment of improvement using the Clinical Global Impression-Improvement (CGI-I), and the incidence of treatment-related adverse events.

Results: Ninety-one participants completed the study through the initial 12-month study period. Sixty-two participants consented to the long-term follow-up with 57 completing the 24-month follow-up. Significant improvements in the total rTNSS were reflected in a median change from baseline of -3.0 or -4.0 at all timepoints (P < .001). Greater than 80.0% of participants achieved the minimum clinically important difference (MCID) of improvement by ≥1 point on the rTNSS at all follow-ups. Total RQLQ scores indicated significant improvement (P < .0001) in quality of life. Over 77% of participants achieved the MCID (≥0.5 points) for the total RQLQ score. According to the CGI-I, ≥83.0% experienced improvement at all but the 12-month visit (61.9%). One participant experienced two treatment-related serious adverse events (epistaxis and retained pledget). A total of 29 nonserious treatment-related AEs were reported in 23 participants; most events were transient and resolved with little to no intervention.

Conclusions: Cryotherapy significantly and clinically improves rhinitis symptoms and quality of life with outcomes that are durable through 24 months after treatment.

Level of evidence: 4 Laryngoscope, 131:1952-1957, 2021.

Keywords: Allergic rhinitis; chronic rhinitis; cryotherapy; nonallergic rhinitis; posterior nasal nerve cryoablation.

© 2021 The Authors. The Laryngoscope published by Wiley Periodicals LLC on behalf of The American Laryngological, Rhinological and Otological Society, Inc.

Figures

Fig. 1

Change in median total reflective Total Nasal Symptom Score (rTNSS) over time. Error bars indicate the interquartile range at each time point. Follow‐up periods through 9 months were reported previously by Chang et al.

Fig. 2

Clinical global impression of improvement (CGI–I). The CGI–I is a physician‐completed survey indicating the perception of patient improvement compared with baseline. The any improvement category is the sum of the very much improved, much improved, and minimally improved categories.