Radiofrequency Neurolysis of the Posterior Nasal Nerve: A Systematic Review and Meta-Analysis.

Abstract

Temperature-controlled radiofrequency (TCRF) neurolysis of the posterior nasal nerve is a minimally invasive treatment for chronic rhinitis. While early studies show short-term efficacy, long-term durability remains unclear. This study evaluated the short- and long-term efficacy and safety of TCRF neurolysis across discrete follow-up intervals. PubMed/MEDLINE, Embase, and the Cochrane Library were searched from inception to March 2026. Following PRISMA 2020 guidelines (PROSPERO: CRD420261345320), studies evaluating adults undergoing TCRF neurolysis for chronic rhinitis with quantitative outcomes were included. Random-effects meta-analyses pooled outcomes at 3 months, 6 months, 12 months, 2 years, and 3 years. Twelve studies (924 patients) were included. TCRF neurolysis significantly reduced total nasal symptom scores (rTNSS) across all intervals: 3 months (-3.96, 95% CI -4.26 to -3.67), 6 months (-4.50, 95% CI -4.91 to -4.09), 12 months (-4.70, 95% CI -5.04 to -4.37), 2 years (-5.06, 95% CI -5.67 to -4.44), and 3 years (-4.59, 95% CI -5.00 to -4.19). Symptom responder rates (≥ 30% improvement) rose from 74% at 3 months to 81%-84% during long-term follow-up. Mini Rhinoconjunctivitis Quality of Life Questionnaire scores demonstrated sustained improvements up to 3 years. Adverse events were infrequent, minor, and transient. TCRF neurolysis provides safe, clinically meaningful, and durable improvements in nasal symptoms and quality of life for up to 3 years, offering a robust therapeutic option for medically refractory chronic rhinitis.