J Rhinol.  2024 Jul;31(2):57-66. 10.18787/jr.2024.00015.

Effectiveness of ClariFix (Cryoablation) of the Posterior Nasal Nerve on Nasal Symptoms in Patients With Chronic Rhinitis: A Systematic Review and Meta-Analysis

• Choi BY
• Hwang SH
• Kim DH

• KMID: 2558231
• DOI: http://doi.org/10.18787/jr.2024.00015

Abstract

Background and Objectives
The present study evaluated the efficacy of cryoablation of the posterior nasal nerve in alleviating symptoms associated with chronic rhinitis.
Methods
A systematic review of pertinent literature sourced from PubMed, Scopus, Embase, Web of Science, and Cochrane databases was conducted through May 2024. The analysis focused on studies that appraised changes in quality of life and rhinitis-associated symptomatology before and after cryoablation treatment.
Results
A total of seven studies (495 patients) were included in the analysis. Significant improvements in rhinitis-related symptoms were observed in patients undergoing cryoablation, irrespective of etiology (allergic or nonallergic rhinitis). Furthermore, cryoablation yielded improvements in disease-specific quality of life, as measured by the Rhinoconjunctivitis Quality of Life Questionnaire. Notably, a clinically significant reduction (≥30% decrease from baseline) in total nasal symptomatology was noted in 71% of cases following cryoablation. Regarding the incidence of adverse effects, nasal dryness, epistaxis, ocular symptoms, and palatal numbness occurred in <5% of patients, while postoperative pain occurred in 10% and headache in 20% of patients who underwent treatment. In subtype analysis, the total nasal symptom score in nonallergic rhinitis showed a significantly increasing pattern over time (p=0.0017).
Conclusion
Cryoablation of the posterior nasal nerve appears to yield a decrease in subjective nasal symptom scores and an improvement in disease-specific quality of life. Notably, these effects persisted for up to 12 months post-treatment, with marked improvements observed in both allergic and nonallergic rhinitis subtypes.

Keyword

Rhinitis; Quality of life; Nose; Cryotherapy; Meta-analysis

Figure

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  Fig. 1. Flowchart depicting the article search process and selection of studies for analysis.

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  Fig. 2. Response rates after cryotherapy treatment (A), change of TNSSs from baseline after cryotherapy treatment (B), and change of RQLQ scores from baseline after cryotherapy treatment (C) [3-9]. TNSS, total nasal symptom score; RQLQ, Rhinoconjunctivitis Quality of Life Questionnaire.

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  Fig. 3. Changes in the TNSS subdomain after cryotherapy treatment for congestion (A), itching (B), rhinorrhea (C), and sneezing (D) [3-7,9]. TNSS, total nasal symptom score.

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  Fig. 4. Changes in TNSSs after cryotherapy treatment for AR (A) and NAR (B) [4,6,7,9]. TNSS, total nasal symptom score; AR, allergic rhinitis; NAR, nonallergic rhinitis.

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  Fig. 5. Incidence of nasal dryness (A), epistaxis (B), ocular symptoms (C), palatal numbness (D), postoperative pain (E), and headache (F) after cryotherapy treatment for chronic rhinitis [3-5,7,9].

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