Three-Year Outcomes After Temperature-Controlled Radiofrequency Ablation of the Posterior Nasal Nerve for Chronic Rhinitis

Abstract

Background: Chronic rhinitis (CR) is characterized by refractory symptoms such as rhinorrhea, sneezing, nasal congestion, postnasal drip (PND), and cough. Most patients do not achieve lasting symptom relief with medical management. Objective: To evaluate the long-term efficacy and safety of temperature-controlled radiofrequency treatment targeting posterior nasal nerves (PNNs) for CR. Methods: This prospective, single-arm, open-label, multicenter study included patients aged 18–85 years across 19 centers in the United States and Germany. Outcome measures included reflective Total Nasal Symptom Score (rTNSS), PND and cough scores, and the Mini Rhinoconjunctivitis Quality of Life Questionnaire (MiniRQLQ). Outcomes, including adverse events, were reported through 3 years post-procedure. Setting: All procedures were performed in an outpatient office-based setting. Results: One hundred twenty-nine patients received treatment; 101 completed 3-year follow-up. The adjusted mean rTNSS Score improved from 7.8 (95% confidence interval [CI]: 7.5-8.1) at baseline to 3.2 (95% CI: 2.8-3.7) at 3 years (mean change: −4.5 [95% CI: −5.1 to −4.0]; P < .001). Rhinorrhea symptom scores improved from 2.6 to 1.2 (55.8% reduction). Compared to baseline, at 3 years, adjusted mean cough and PND scores declined from 1.3 to 0.4 (mean change: −0.9; P < .001, 69% reduction) and from 2.4 to 1.2 (mean change: −1.2; P < .001, 50% reduction), respectively. MiniRQLQ scores were significantly reduced from an adjusted mean of 3.0 (95% CI: 2.8-3.2) at baseline to 1.2 (95% CI: 1.0-1. 4) at 3-year follow-up; P < .001. No serious device- or procedure-related adverse events were reported. Conclusion: A single temperature-controlled radiofrequency treatment of the PNN safely and effectively reduced CR symptoms, including cough and PND, improved quality of life, and decreased medication burden through a period of 3 years with no serious adverse events.