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. 2021 Jan 29:12:2152656720988565.
doi: 10.1177/2152656720988565. eCollection 2021 Jan-Dec.

Evaluation of In-Office Cryoablation of Posterior Nasal Nerves for the Treatment of Rhinitis

John A Gerka Stuyt  1 , Lauren Luk  1 , David Keschner  1 , Rohit Garg  1
Affiliations

Evaluation of In-Office Cryoablation of Posterior Nasal Nerves for the Treatment of Rhinitis

John A Gerka Stuyt et al. Allergy Rhinol (Providence). .

Abstract

Background: Chronic rhinitis is a common condition generally treated with medical therapies. However, 10-22% of patients are refractory to medical therapies. A cryotherapy handheld device targeting the postganglionic nerve fibers of the posterior nasal nerve (PNN) now serves as an additional option for therapy. This study evaluates the efficacy of the cryosurgical ablation device of the PNN in the clinic setting.

Methods: This was a prospective single-arm trial of 24 adult patients at seven locations within a large health maintenance organization. Patients with chronic rhinitis that failed medical therapy were offered an in-office cryoablation of PNN. Patients completed the Total Nasal Symptom Score (TNSS) questionnaire consisting of 5 items reported based on the previous 12 hours and 2 weeks at the following time points: pre-treatment, 30 days, 90 days and 1 year post-treatment.

Results: Following cryoablation of the PNN, the TNSS 12-hour symptom score improved from 6.92 (±2.9) to 3.17 (±2.4, P < 0.001) at 30 days, 2.92 (±1.4, P < 0.001) at 90 days and 3.08 (±2.6, P < 0.001) at 1 year post treatment. Similar results were noted for the 2 weeks scores improving from 7.75 (±3.1) to 3.79 (±2.1, P < 0.001) at 30 days, 3.88 (±1.9, P < 0.001) at 90 days and 3.76 (±2.1, P < 0.001) at 1 year post-treatment. 64.7% of respondents stated the procedure decreased or eliminated nasal sprays.

Conclusions: Our independent evaluation of cryoablation of the PNN shows improvement in nasal symptoms over a 1 year period and is consistent with other published data.

Keywords: congestion; cryoablation; cryosurgery; cryosurgical ablation; posterior nasal nerve; rhinitis; rhinorrhea.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
TNSS questionnaire. Items evaluated include nasal congestion, runny nose, nasal itching, sneezing and difficulty sleeping throughout the past 12 hours and 2 weeks.
Figure 2.
Figure 2.
12 hour and 2-week mean TNSS score pre-procedure, 30 days, 90 days, and 1 year post-procedure. Error bars represent standard deviation, *represents statistical significance (P < 0.05).
Figure 3.
Figure 3.
A, Non-allergic, mixed and allergic rhinitis 12 hour mean TNSS at baseline (pre-procedure), 30 days, 90 days, and 1 year post-procedure. B, Non-allergic, mixed and allergic rhinitis 2-week mean TNSS at baseline (pre-procedure), 30 days, 90 days, and 1 year post-procedure. Error bars represent standard deviation, *represents statistical significance (P < 0.05).
Figure 4.
Figure 4.
A, 12 hour mean TNSS subdomain symptoms evaluated at baseline (pre-procedure), 30 days, 90 days, and 1 year post-procedure. B, 2-week mean TNSS subdomain symptoms evaluated at baseline (pre-procedure), 30 days, 90 days, and 1 year post-procedure. Error bars represent standard deviation, *represents statistical significance (P < 0.05).
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