Cryosurgery for the treatment of chronic rhinitis

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.