Comparative Effectiveness of Cryotherapy and Radiofrequency Ablation for Chronic Rhinitis: A Systemic Review and Meta-analysis.

OBJECTIVE: Multiple minimally invasive techniques for chronic rhinitis treatment focus on posterior nasal nerve ablation. We analyzed the efficacy of cryotherapy and radiofrequency ablation in alleviating symptoms in allergic and nonallergic rhinitis patients.

METHODS: We retrieved studies from PubMed, SCOPUS, Embase, Web of Science, and Cochrane Database up to July 2023. The impact on quality of life and symptom ratings of rhinitis were evaluated and extracted.

RESULTS: Analysis of 12 studies involving 788 patients analyzed significant improvements in the quality of life and rhinitis-related symptoms (nasal obstruction, itching, rhinorrhea, and sneezing) of patients treated with cryotherapy or radiofrequency ablation (symptom score 24 months/quality score 3 months). However, radiofrequency ablation had a more positive effect on nasal symptoms after 3 months compared to cryotherapy. Nonallergic rhinitis patients responded more favorably to posterior nerve ablation. Both techniques enhanced disease-specific quality of life during the initial 3 months of treatment (cryotherapy 84.6% and radiofrequency 81.6%, p = 0.5636). After 3 months of treatment, clinical improvement in all nasal symptoms (minimal clinically important difference in the total nasal symptom score > 1.0 points) was seen in 81.8% and 91.9% in patients with cryotherapy and radiofrequency, respectively (p = 0.0048), suggesting that radiofrequency may achieve greater clinical improvement.

CONCLUSION: Rhinitis-associated subjective symptom scores and quality of life may be improved by both cryotherapy and radiofrequency ablation. The ablation was more efficacious for nasal symptoms in patients with nonallergic rhinitis. To corroborate these findings, further randomized controlled studies directly comparing two techniques are warranted.