Two‐Year Outcomes After Radiofrequency Neurolysis of Posterior Nasal Nerve in Chronic Rhinitis

Abstract

ObjectiveTo assess the long‐term safety and effectiveness of temperature‐controlled radiofrequency (TCRF) neurolysis of the posterior nasal nerve (PNN), a minimally invasive treatment for chronic rhinitis.MethodsA prospective, single‐arm study of 129 patients at 16 centers (United States, Germany) was conducted. Patient‐reported outcome measures were the 24‐h reflective total nasal symptom score (rTNSS) and mini rhinoconjunctivitis quality of life questionnaire (MiniRQLQ). Postnasal drip and cough symptoms were assessed using a 4‐point scale.ResultsThe mean pretreatment rTNSS was 7.8 (95% CI, 7.5–8.1). The significant rTNSS treatment effect at 3 months (−4.2 [95% CI, −4.6 to −3.8]; p < 0.001) was sustained through 2 years (−4.5 [95% CI, −5.0 to −3.9]; p < 0.001), a 57.7% improvement. At 2 years, the proportion of patients with a minimal clinically important difference (MCID) of ≥30% improvement in rTNSS from baseline was 80.0% (95% CI, 71.4%–86.5%). Individual postnasal drip and cough symptom scores were significantly improved from baseline through 2 years. The proportion of patients who reached the MCID for the MiniRQLQ (≥0.4‐point improvement) at 2 years was 77.4% (95% CI, 68.5%–84.3%). Of 81 patients using chronic rhinitis medications at baseline, 61.7% either stopped all medication use (28.4%) or stopped or decreased (33.3%) use of ≥1 medication class at 2 years. No device/procedure‐related serious adverse events were reported throughout 2 years.ConclusionTCRF neurolysis of the PNN resulted in sustained improvements in chronic rhinitis symptom burden and quality of life through 2 years, accompanied by a substantial decrease in medication burden.Level of Evidence4 Laryngoscope, 2023