Temperature-controlled radiofrequency neurolysis effectively treats chronic rhinitis symptoms

USA: Temperature-controlled radiofrequency (TCRF) neurolysis significantly reduced the symptom burden of chronic rhinitis and improved the quality of life of the patients through 24 months postprocedure, states study results published in Allergy & Rhinology.

In chronic rhinitis, posterior nasal neurectomy (PNN) is thought to induce denervation of the nasal mucosa and relieve the symptoms. Minimally invasive treatment options targeting the PNN for treating chronic rhinitis include TCRF neurolysis, in which the temperature of the treatment area is continually measured and energy delivery to the tissue is varied to maintain a 60 °C temperature. TCRF neurolysis enables focused treatment without significant damage to overlying mucosa and adjacent tissue. TCRF neurolysis of PNN has been shown to reduce the symptom burden of patients with chronic rhinitis

Dale Ehmer, Ear, Nose, and Throat Associates of Texas, USA, and colleagues conducted a study to evaluate the long-term safety and effectiveness of TCRF neurolysis of the PNN for the treatment of chronic rhinitis.

Researchers collected reflective total nasal symptom score (rTNSS) and the responses to a study-specific quality of life questionnaire and patient satisfaction survey at 24 months as a prospective extension of an earlier, 12-month single-arm study. 47 patients completed an initial 12-month follow-up after treatment with the study device, of which 34 patients gave consent to participate in the study extension and completed a 24-month follow-up.

Key findings of the study,

• The mean rTNSS of the long-term follow-up patients improved from 8.4 at baseline to 2.9, P < .001 at 24 months, a 65.5% improvement.

• On a 6-point scale (0-5), postnasal drip improved from a mean of 4.1 to 2.1 and chronic cough improved from 3.2 to 0.9 from baseline through 24 months; P < .001 for both measures.

• At 24 months 88.2% of patients achieved a minimal clinically important difference of 30% improvement from baseline.

• At 24 months, 24% of patients were taking overall fewer and 15% taking overall more rhinitis medication classes than at baseline

• Patients reported a higher quality of life in terms of sleep, well-being, and lower oral medication/nasal spray use at 24 months.

• There were no serious adverse events considered related to the procedure in the 12-24-month period.

From the study results, the authors conclude that the TCRF neurolysis of the PNN results in a significant and durable reduction in the symptom burden of chronic rhinitis through 24 months postprocedure. Quality of life in patients improved in terms of better sleep quality, personal feelings, and well-being, and lower oral medication/nasal spray use. Patient-reported satisfaction remained high through 24 months postprocedure.

As Concurrent medication usage was evaluated in this rational study, future studies with a medication control strategy could be useful to explore any confounding effects of medication changes, the authors commented.

Reference:

Ehmer D, McDuffie CM, McIntyre JB, Davis BM, Mehendale NH, Willis JH, Watkins JP, Kakarlapudi VV. Long-term Outcomes Following Temperature-Controlled Radiofrequency Neurolysis for the Treatment of Chronic Rhinitis. Allergy Rhinol (Providence). 2022 May 29;13:21526575221096045. doi: 10.1177/21526575221096045. PMID: 35663498; PMCID: PMC9158436.