Radiofrequency Ablation Versus Laser Neurolysis of the Posterior Nasal Nerve in Patients With Chronic Rhinitis.

Abstract

To compare the clinical outcomes of radiofrequency ablation of the intraturbinate segment of the posterior nasal nerve (RAPN) alone versus combined RAPN with CO₂ laser posterior nasal nerve neurolysis (RPN3) in patients with chronic rhinitis refractory to medical therapy. Retrospective cohort study. Single tertiary care center. Adult patients with chronic rhinitis unresponsive to medical treatment for over 6 months who underwent either RAPN or RPN3 between February 2023 and May 2024 were included. Inclusion criteria were 24-hour reflective total nasal symptom score (rTNSS) ≥ 3, rhinorrhea score ≥1, and NOSE score ≥11. Exclusion criteria included chronic rhinosinusitis, nasal polyps, and coagulopathy. Demographics and comorbidities were documented. Primary endpoints were changes in rTNSS, NOSE scores, and response rate (≥30% improvement from baseline) at 1-, 3-, and 6-months posttreatment. A total of 101 patients were analyzed (RPN3: 76; RAPN: 25). Baseline rTNSS and NOSE scores were comparable between the two groups (P = .144 and .414, respectively). Both groups demonstrated significant improvements in rTNSS and NOSE scores at all follow-up points (P < .001). From 1 to 6 months, RPN3 achieved significantly greater improvements compared to RAPN (P = .039-.045), particularly in the rhinorrhea and nasal itching sub-scores (P = .003-.039). Response rates for rTNSS ranged from 91% to 100% in the RPN3 group and 84% to 96% in the RAPN group. Both RAPN and RPN3 are effective in treating chronic rhinitis unresponsive to medication. The addition of CO₂ laser posterior nasal nerve neurolysis (RPN3) provides superior symptomatic relief, particularly for rhinorrhea and nasal itching.