BACKGROUND:Chronic rhinitis impacts 60 million Americans and is associated with significant costs for patients. Although medical treatments are first line, some patients require surgical intervention such as vidian or posterial nasal neurectomy. Previous reviews have investigated the role of surgical management in chronic rhinitis, but none have investigated a longstanding treatment with recent interest: cryotherapy.

OBJECTIVE:To identify the safety, efficacy, and durability of treatment response of cryotherapy in treating chronic rhinitis.

METHODS:A systematic literature review was performed to identify studies that investigated the utility of cryotherapy in chronic rhinitis. Only studies with the primary objective of assessing the efficacy of cryotherapy on chronic rhinitis were included. Patients were classified as allergic rhinitis, nonallergic rhinitis (vasomotor rhinitis), or mixed rhinitis using the original author's criteria. Data were extracted regarding reported complications, treatment efficacy, and length of follow-up.

RESULTS:A total of 110 abstracts were identified, of which 15 were included in this review. Epistaxis and nasal obstruction were commonly reported complications. No serious adverse events were reported. For obstructive symptoms,"reduced"symptoms were reported in 63.4% to 100% of patients. In regard to rhinorrhea, reports of reduced symptoms were experienced from 77% to 100% of patients. Seven studies used only patient-reported improvements without stratifying results based on symptom type; general improvements ranged from 67% to 100%. Nine studies noted symptom improvement in nonallergic cohorts ranging from 67% to 97.5% of patients. Four studies noted improvement in allergic cohorts ranging from 63.4% to 80% of patients. Two studies noted improvement in patients with mixed pictures ranging from 92.5% to 100%.

CONCLUSIONS:Although cryotherapy appears safe and efficacious, heterogeneous past investigations with low-quality evidence make strong, evidence-based recommendations difficult to make. Further study with validated metrics and controlled populations is certainly warranted and should be encouraged.

The efficacy and safety of the application of essential oils for the prevention of acute respiratory diseases and alleviation of clinical manifestations of rhinitis was evaluated in a group of children aged 3-4 years. It was shown that inhalation of a mixture of essential oils resulted in a 42.5% decrease of the prevalence of the above pathologies. Specifically, they developed only in each third child from the group of frequently ill children. No side effects of the treatment were documented. 25% of the children suffered only from mild acute respiratory diseases, fever was absent in 5%. The severity and duration of the symptoms of rhinitis decreased in more than 80% of the children. Simultaneously, the requirement of decongestants and local (intranasal) antibiotics was reduced.