CRYOABLATION FOR CHRONIC RHINITIS
Author(s)
EUNSUN LIM, MPH, RN.
National Evidence-based Healthcare Collaborating Agency (NECA), Seoul, Korea, Republic of.
National Evidence-based Healthcare Collaborating Agency (NECA), Seoul, Korea, Republic of.
OBJECTIVES: The purpose of this systematic review is to determine the safety and effectiveness of cryoablation of the posterior nasal nerve in patients with chronic rhinitis.
METHODS: This review retrieved studies from Ovid-Medline, Ovid-Embase, the Cochrane Database and five Korean databases, including KoreaMed up to June 2024. Studies that evaluated rhinitis-related symptom scores, changes in medication usage, and procedure-related complications, including sham-controlled studies as well as before-and-after cryoablation studies, were included.
RESULTS: A total of eight studies were reviewed. Patients who underwent cryoablation showed significantly greater symptom improvement compared to the sham group over three months (p < 0.001), with 81.3-82.8% of intervention patients achieving the minimally clinically important difference (MCID). Seven case series also reported significant symptom improvements across all measured indices, with clinical global impression improvement scores ranging from 80% to 89.7%. The MCID was achieved in 70.7-92.9% of cases. The most frequently discontinued medications after the intervention were intranasal corticosteroids (22.5-42.5%) and intranasal antihistamines (26.8-37.5%). The proportion of patients who discontinued or reduced medication use by rhinitis type was as follows: mixed-type (100%), non-allergic (66.6%), and allergic (33.3%) rhinitis. Major complications included dry eyes (2%), dysgeusia or hyposmia (1.6%), and palate numbness (0.8-28.6%), all of which resolved without additional treatment. Minor complications included headaches (3-40%) and post-procedural pain or discomfort (1-33.3%).
CONCLUSIONS: The New Health Technology Assessment Committee determined Cryoablation for chronic rhinitis is a safe and effective treatment for relieving rhinitis symptoms in adults by accessing the posterior middle or inferior meatus, where the posterior nasal nerve is located, under endoscopic guidance and ablating the tissue around the nerve using a cryoprobe, and applying a temperature of -40°C or lower to the target area for 30-60 seconds per site, and announced through the Korean Ministry of Health and Welfare bulletin No. 2025-28 (17 February 2025).
METHODS: This review retrieved studies from Ovid-Medline, Ovid-Embase, the Cochrane Database and five Korean databases, including KoreaMed up to June 2024. Studies that evaluated rhinitis-related symptom scores, changes in medication usage, and procedure-related complications, including sham-controlled studies as well as before-and-after cryoablation studies, were included.
RESULTS: A total of eight studies were reviewed. Patients who underwent cryoablation showed significantly greater symptom improvement compared to the sham group over three months (p < 0.001), with 81.3-82.8% of intervention patients achieving the minimally clinically important difference (MCID). Seven case series also reported significant symptom improvements across all measured indices, with clinical global impression improvement scores ranging from 80% to 89.7%. The MCID was achieved in 70.7-92.9% of cases. The most frequently discontinued medications after the intervention were intranasal corticosteroids (22.5-42.5%) and intranasal antihistamines (26.8-37.5%). The proportion of patients who discontinued or reduced medication use by rhinitis type was as follows: mixed-type (100%), non-allergic (66.6%), and allergic (33.3%) rhinitis. Major complications included dry eyes (2%), dysgeusia or hyposmia (1.6%), and palate numbness (0.8-28.6%), all of which resolved without additional treatment. Minor complications included headaches (3-40%) and post-procedural pain or discomfort (1-33.3%).
CONCLUSIONS: The New Health Technology Assessment Committee determined Cryoablation for chronic rhinitis is a safe and effective treatment for relieving rhinitis symptoms in adults by accessing the posterior middle or inferior meatus, where the posterior nasal nerve is located, under endoscopic guidance and ablating the tissue around the nerve using a cryoprobe, and applying a temperature of -40°C or lower to the target area for 30-60 seconds per site, and announced through the Korean Ministry of Health and Welfare bulletin No. 2025-28 (17 February 2025).
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
HTA201
Topic
Clinical Outcomes, Health Technology Assessment, Medical Technologies
Topic Subcategory
Decision & Deliberative Processes
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)