Posterior Nasal Nerve Neurolysis : Comparison of Radiofrequency Intraturbinate Segment Intervention vs. Combining Laser Ablation

Sunday, October 12, 2025

1:00 PM - 1:06 PM EDT

Location: 125

Disclosure(s):

Chien-Yu Huang, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: This study aimed to evaluate the outcome of combining radiofrequency ablation of the intraturbinate segment of the posterior nasal nerve (RAPN) with CO2 laser posterior nasal nerve neurolysis (combined as RPN3), compared to RAPN alone in treating patients with chronic rhinitis unresponsive to pharmacological therapy.

Methods: A retrospective cohort study was conducted from February 2023 to May 2024 on adult patients with chronic rhinitis who demonstrated poor response to medication for more than 6 months and received either RPN3 or RAPN in our hospital. Patients with a total 24-hour reflective total nasal symptom score (rTNSS) ≥3, rhinorrhea score ≥1, and nasal obstruction symptom evaluation (NOSE) scores ≥11 were included. Patients with chronic rhinosinusitis, nasal polyps, or coagulopathy were excluded. Patient characteristics including age, sex, BMI, history of nasal surgery, rhinitis medicamentosa, obstructive sleep apnea, hypertension were documented. The primary endpoints were changes from baseline in 24-hour rTNSS, NOSE scores, and response rate (defined as score improvement ≥30% from baseline)

Results: A total of 101 patients were included; 76 received RPN3 and 25 received RAPN alone. The baseline rTNSS was 8.2 (95% CI: 7.6 to 8.7) and 7.4 (95% CI: 6.3 to 8.4) for RPN3 and RAPN, respectively, with no statistically significant difference(p=0.144). The 1,3,6-month rTNSS and NOSE changes showed significant improvement compared to baseline (p < 0.001) in both groups. The RPN3 approach showed significantly greater improvement than RAPN throughout 1-6-month follow-ups (p=0.032-0.039) and subscore analysis with rhinorrhea and itching (p=0.003-0.039). The response rates for rTNSS were 90.8-100% and 84-96% in the RPN3 and RAPN groups, respectively.

Conclusions: Both RPN3 and RAPN demonstrated significant improvement in medication-refractory chronic rhinitis, with high response rates. The RPN3 showed superior efficacy compared to RAPN, particularly in rhinorrhea and nasal itching, suggesting enhanced therapeutic benefits through the addition of CO2 laser posterior nasal nerve neurolysis.

Presenting Author(s)

Chien-Yu Huang, MD

Chief of Otolaryngology Department
Chia-Yi Hospital
Chiayi City, Chiayi, Taiwan (Republic of China)

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Senior Author(s)

Chien-Yu Huang, MD

Chief of Otolaryngology Department
Chia-Yi Hospital
Chiayi City, Chiayi, Taiwan (Republic of China)

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

YH

Ying-Shuo Hsu, MD,PhD

Otolaryngologist
Shin Kong Wu Ho-Su Memorial Hospital
Taipei, Taipei, Taiwan (Republic of China)

Disclosure information not submitted.
YH

Yi Li Hwang, DDS, MS

Oral Maxillofacial Surgeon
Department of Oral and Maxillofacial Surgery, Chia-Yi Chang Gung Memorial Hospital, Taiwan (Republic of China)

Disclosure information not submitted.
JL

Jyun Yi Liao, MD

Attending
Department of Otolaryngology-Head and Neck Surgery, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Taiwan (Republic of China)

Disclosure information not submitted.
TS

Ting Yu Shih, NP

Department of Otolaryngology-Head and Neck Surgery, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Taiwan (Republic of China)

Disclosure information not submitted.
HT

Han Lo Teng, BS

Department of Otolaryngology-Head and Neck Surgery, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Taiwan (Republic of China)

Disclosure information not submitted.