Cryosurgery for the treatment of chronic rhinitis

Abstract

In 1970, cryosurgery was reported as effective treatment for chronic rhinitis.1 Since that time, several hundred patients have been treated with better results, almost no complications, and simplification of the techniques. Improved equipment, selection of patients, probe application, replacement of Freon with Nitrous Oxide as the cooling agent, and prevention of complications have been reported.5 Similar success has been reported by colleagues here and in England.4 Subjective and objective evaluation after three to four years suggests the superiority of this technique. While relief of obstruction is almost certain, even in the few patients for whom more than one treatment has been necessary, rhinorrhea and sneezing are not always relieved by simply destroying diseased mucosa. More recently, as a result of reports of relief of the latter symptoms by vidian nerve section,2,3 patients have been treated with a “hooked” nasal probe positioned on branches of the nerves at the spheno‐palatine foramen, either at the time of turbinectomy or later. The latter procedure is not considered to destroy the nerves permanently and is considered a “treatment” because nerves regenerate. At present cryosurgery is frequently used when mucosal disease results in “failure” of nasal septal surgery and as a complement of conventional reconstructive surgery. Relatively inexpensive Nitrous Oxide cryoprobes should make the technique available for most otolaryngologists.

Cryosurgical posterior nasal tissue ablation for the treatment of rhinitis

“…Cryoablative techniques have been used in the head and neck region for a number of different applications . Cryotherapy offers the advantage of ablating soft tissue and nerve with predictable depth of penetration, while preserving arterial vascular supply to the region, hence minimizing the risk of necrosis.…”

The Efficacy of Cryosurgery Combined with Laser Surgery in the Treatment of Perennial Allergic Rhinitis

“…Ozenberger [5] reported that a group of 46 patients with chronic rhinitis were treated with cryosurgery. After a reduction of diseased mucosa, turbinates re-epithelialized with healthier mucosa after several weeks, and subjective and objective improvements were found.…”

“…Most patients are treated with antiallergic drugs or allergic desensitization; however, a Furukawa/Kakimoto/Himeno/Yamashita considerable number are refractory to such treatments [2]. Various surgical techniques have been described such as inferior turbinectomy [3,4], cryotherapy [5,6], chemical cauterization [7,8], electrocautery [9,10] and vidian neurectomy [11,12]. Because most of these procedures are associated with a risk of bleeding, uncontrolled damage of the mucosa, pain and atrophic rhinitis, a more comfortable and effective method is required [2].…”

Surgery of the turbinates and “empty nose” syndrome

“…Ozenberger, one of the early advocates of this method, discovered that through the destruction of parasympathic nerves due to coldness, allergic-induced rhinitis in particular can be treated favourably (“... after freezing the nerve area ... relief of sneezing is almost immediate.”) [105]. …”