Efficacy of intranasal cryotherapy in relief of symptoms and release from steroid dependence
Reviewed by Madhup K Chaurasia

Chronic rhinitis can be very persistent, and often entails unremitting dependence on medications. Surgery, though generally simple, can still result in complications. Cryoablation of posterior nasal nerve can be done as an outpatient procedure under local anaesthesia, and surgery may be avoided. In this prospective study of 36 chronic rhinitis patients who failed medical treatment, mainly with steroids, the authors used this cryotherapy alone in 18 patients. In the other 18, both cryotherapy and inferior turbinate reduction was done. These patients had higher preoperative symptom scores. Symptoms were assessed by three validated subjective scoring systems, namely Total Nasal Symptom Score (TNSS), Sino-Nasal Outcome Test (SNOT) and Nasal Obstruction Symptom Evaluation (NOSE). Peak inspiratory nasal flow was also used for evaluation. The first postoperative review was in 4–6 weeks, after which 50% of patients could be discharged. The mean follow-up was 8 months. Based on this scoring system, both groups of patients benefitted. The reduction in symptom scores was greater in the group receiving both therapies because they started with a higher score. This is the first study to use peak inspiratory nasal airflow measurements, and 96% of patients showed improvement in this. Patients requiring intranasal steroids decreased from 97 to 36%. There was no symptom decay in the longest follow-up, which was 8 months. However, the cost of cryotherapy using ClariFix was still three times the cost of medicinal treatment. Cryotherapy therefore remains an evolving modality and further studies are required.

Intranasal cryotherapy for refractory chronic rhinitis: a prospective study.
Arnols C, Morris S, Bodger O, Whittet H.
J LARYNGOL OTOL 
2026;140(4):396–402.