Improvement in Nasal Symptoms of Chronic Rhinitis after Cryoablation of the Posterior Nasal Nerve

Abstract

Abstract Objective To determine the efficacy of posterior nasal nerve (PNN) cryoablation for improving the symptoms of chronic rhinitis. Study Design Retrospective cohort study. Setting A private practice. Methods This study evaluated medication usage and adverse effects of in‐office PNN cryoablation with a handheld device in patients > 18 years with chronic (>6 months) allergic or nonallergic rhinitis for whom medical management failed. The total nasal symptom score (TNSS) and mini rhinoconjunctivitis quality of life questionnaire (mRQLQ) scores were compared before and after treatment. Results This study included 127 patients with a mean age of 52.4 ± 16.9 years; 60.6% of patients were female and 49.6% had allergic rhinitis. Mean symptom scores decreased from 5.94 (95% confidence interval [CI], 5.51‐6.43) to 3.44 (95% CI, 2.97‐3.81, P < .001) after the procedure, with clinically important decreases in 75 (59.1%) patients. For patients with baseline TNSS values of ≥4, 63.5% (66/104) had a clinically important decrease, whereas only 39.1% (9/23) of those with the lower baseline did (P = .04). Mean mRQLQ scores also decreased from 2.51 (95% CI, 2.29‐2.72) to 1.28 (95% CI, 1.20‐1.47, P < .001) after the procedure. Seventy‐eight of 273 (28.6%) medications were discontinued after the procedure. Adverse effects occurred in 18.1% (23/127) of patients with headache as the most common. Conclusion PNN cryoablation improves nasal symptoms and quality of life in patients with chronic rhinitis. Patients with a higher baseline TNSS are more likely to experience significant symptomatic improvement.

Keywords

• allergic rhinitis
• chronic rhinitis
• cryoablation
• cryotherapy
• nonallergic rhinitis
• posterior nasal nerve