- Design
- Prospective, multicentre, non-randomised observational registry
- Population
- 354 adults with allergic or non-allergic chronic rhinitis, 22 practices
- Primary outcome
- Change in reflective Total Nasal Symptom Score to 24 months
- Effect
- Over 73% responders at all follow-ups; no serious device-related adverse events
This prospective, non-randomised registry followed 354 adults with allergic or non-allergic chronic rhinitis treated with a nasal cryotherapy device at 22 tertiary and private practices, for up to 24 months. The registry concerned a single commercial device.
About three-quarters were symptom responders (at least a 1-point fall in total nasal symptom score) and quality-of-life responders at every follow-up, and clinicians recorded improvement in 87% at three months. People with worse baseline symptoms improved more. No serious device-related adverse events were reported; minor events were transient.
The safety data are the more useful part. Without a sham or medical-therapy comparison, the efficacy figures cannot be separated from placebo, natural fluctuation and regression to the mean — all large in rhinitis. It may be an option to discuss for persistent rhinorrhoea after an adequate trial of intranasal therapy, where the device is available.
- Optimise intranasal steroid and, for rhinorrhoea, intranasal anticholinergic therapy before considering cryotherapy.
- Consider cryotherapy only after adequate medical treatment has failed.
- Tell patients that the improvement figures come from an uncontrolled registry.
- Expect minor, short-lived discomfort after the procedure.
Why it matters
It supplies longer safety data for a procedure increasingly offered in clinic.
Don't overread it
This was an uncontrolled registry of one device; it cannot show the procedure works better than placebo.
The statistics, in plain English
A responder rate of about 73% sounds high, but without a comparison group it is impossible to know how many would have improved anyway. Symptom scores in rhinitis vary a lot naturally, and patients often enrol when symptoms are worst.
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