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Meta-Analysis
. 2024 Jun 5:13:4.
doi: 10.12688/f1000research.143321.2. eCollection 2024.

The safety and efficacy of spray cryotherapy after endoscopic sinus surgery in chronic rhinosinusitis: A systematic review of randomized controlled trials

Mohammad J J Taha  1 , Obaida Falah  1 , Mohammad T Abuawwad  1 , Ayham R Sara  1 , Adham A Aljariri  2 , Abdulqadir J Nashwan  3 , Ibrahim T Abuawwad  1 , Ahmad J Taha  1 , Abdullah A Elhakim  1 , Majed Akili  1
Affiliations
Meta-Analysis

The safety and efficacy of spray cryotherapy after endoscopic sinus surgery in chronic rhinosinusitis: A systematic review of randomized controlled trials

Mohammad J J Taha et al. F1000Res. .

Abstract

Background: Chronic rhinosinusitis (CRS) is a condition that affects 5-12% of the general population. Endoscopic sinus surgery (ESS) is the preferred treatment because of its few adverse effects and highest success rates. The most common post-operative consequences include synechia, nasal blockage, and disease recurrence. Spray cryotherapy is a novel therapeutic approach with promising outcomes for the treatment of upper airway disorders.This review aimed to investigate the effects of spray cryotherapy (SCT) following ESS in patients with chronic rhinosinusitis.

Methods: Six electronic databases were searched for randomized clinical trials (RCTs). The selected trials were evaluated for methodological quality, and data were extracted by two independent reviewers. The Cochrane risk-of-bias tool was used to assess the quality of evidence.

Results: Three RCTs with 85 patients were included in the final analysis. SCT was related to -16 and -77 reductions in Lund-McKay and SNOT-22 scores after 36 weeks of follow-up, in contrast to a placebo, which showed -10.4, -65. Regarding the side effects of SCT, no adverse effects were reported, and visual assessments showed no pain, visual field loss, or any other ocular complications.

Conclusions: SCT is a new treatment modality after endoscopic sinus surgery that shows an effective post-operative management strategy with better post-operative scales (Lund-McKay, SNOT-22, POSE, and Lund-Kennedy) and less edema, obstruction, crusting, and inflammation with minimal or no side effects. However, further research with longer follow-ups, a larger sample size, and subjective assessment is needed to assess any possible long-term side effects.

Keywords: chronic rhinosinusitis; functional endoscopic sinus surgery; middle meatus antrostomy; nasal polyposis; spray cryotherapy.

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Conflict of interest statement

No competing interests were disclosed.

Figures

Figure 1.
Figure 1.. PRISMA flow chart for included and excluded studies.
Figure 2.
Figure 2.. Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
Figure 3.
Figure 3.. Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
See this image and copyright information in PMC

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