Comparative Effectiveness of Cryotherapy and Radiofrequency Ablation for Chronic Rhinitis: A Systematic Review and Meta-analysis
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Objectives. Multiple minimally invasive techniques for chronic rhinitis treatment focus on posterior nasal nerve ablation. We conducted a systematic review and meta-analysis to evaluate the efficacy of cryotherapy and radiofrequency ab-lation for alleviating symptoms in patients with allergic and nonallergic rhinitis. Methods. We retrieved studies from PubMed, Scopus, Embase, Web of Science, and Cochrane Database up to July 2023. Data on the impact of cryotherapy and radiofrequency ablation on quality of life and symptom ratings of rhinitiswere extracted and evaluated. Results. An analysis of 12 studies involving 788 patients demonstrated significant improvements in quality of life and rhini-tis-related symptoms (nasal obstruction, itching, rhinorrhea, and sneezing) in patients treated with cryotherapy or ra-diofrequency ablation (symptom score at 24 months and quality of life score at 3 months). However, radiofrequencyablation had a more positive effect on nasal symptoms after 3 months than cryotherapy. Nonallergic rhinitis patientsresponded more favorably to posterior nerve ablation than patients with allergic rhinitis. Both techniques enhanceddisease-specific quality of life during the initial 3 months of treatment (cryotherapy, 84.6%; radiofrequency, 81.6%;P =0.564). After 3 months of treatment, a clinical improvement in all nasal symptoms (minimal clinically importantdifference in the total nasal symptom score: >1.0 points) was seen in 81.8% and 91.9% of patients who underwentcryotherapy and radiofrequency ablation, respectively (P =0.005), suggesting that radiofrequency is more likely tolead to clinical improvement. Conclusion. Rhinitis-associated subjective symptom scores and quality of life may be improved by both cryotherapy andradiofrequency ablation. Ablation was more efficacious than cryotherapy for nasal symptoms in patients with nonal-lergic rhinitis. To corroborate these findings, further randomized controlled studies directly comparing these twotechniques are warranted.
Abstract
Objectives. Multiple minimally invasive techniques for chronic rhinitis treatment focus on posterior nasal nerve ablation. We conducted a systematic review and meta-analysis to evaluate the efficacy of cryotherapy and radiofrequency ab-lation for alleviating symptoms in patients with allergic and nonallergic rhinitis. Methods. We retrieved studies from PubMed, Scopus, Embase, Web of Science, and Cochrane Database up to July 2023. Data on the impact of cryotherapy and radiofrequency ablation on quality of life and symptom ratings of rhinitiswere extracted and evaluated. Results. An analysis of 12 studies involving 788 patients demonstrated significant improvements in quality of life and rhini-tis-related symptoms (nasal obstruction, itching, rhinorrhea, and sneezing) in patients treated with cryotherapy or ra-diofrequency ablation (symptom score at 24 months and quality of life score at 3 months). However, radiofrequencyablation had a more positive effect on nasal symptoms after 3 months than cryotherapy. Nonallergic rhinitis patientsresponded more favorably to posterior nerve ablation than patients with allergic rhinitis. Both techniques enhanceddisease-specific quality of life during the initial 3 months of treatment (cryotherapy, 84.6%; radiofrequency, 81.6%;P =0.564). After 3 months of treatment, a clinical improvement in all nasal symptoms (minimal clinically importantdifference in the total nasal symptom score: >1.0 points) was seen in 81.8% and 91.9% of patients who underwentcryotherapy and radiofrequency ablation, respectively (P =0.005), suggesting that radiofrequency is more likely tolead to clinical improvement. Conclusion. Rhinitis-associated subjective symptom scores and quality of life may be improved by both cryotherapy andradiofrequency ablation. Ablation was more efficacious than cryotherapy for nasal symptoms in patients with nonal-lergic rhinitis. To corroborate these findings, further randomized controlled studies directly comparing these twotechniques are warranted.
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