The Effect of Radiofrequency Ablation of Posterior Nasal Nerves on Inflammatory Cytokines, Peak Nasal Inspiratory Flow, and Subjective Symptom Scores in Chronic Rhinitis: A Prospective Clinical Trial

BACKGROUND: Chronic rhinitis (CR) is inflammation of the nasal mucosa, causing a multitude of symptoms. Temperature-controlled radiofrequency neurolysis (RFN) of the posterior nasal nerve (PNN) is a treatment for CR. In allergic rhinitis (AR), Type 2 cytokines are drivers of symptom severity. This study explores whether RFN's symptomatic improvements are linked to changes in nasal airflow and local cytokine levels. METHODS: This prospective, single-arm study was conducted at the Texas Sinus Institute at The University of Texas Health Science Center at Houston. Patients with ≥6 months of CR symptoms, a reflective total nasal symptom score (rTNSS) ≥6, and refractory to medical management were included. Follow-ups occurred at 4 and 12 weeks, with the primary endpoint at 12 weeks. Symptom improvement, peak nasal inspiratory flow (PNIF) and cytokine changes were assessed. RESULTS: = .011). CONCLUSIONS: RFN of the PNN is a safe, effective in-office treatment for CR. While PNIF and group-level cytokines were not consistent indicators of improvement, the correlation between IL-10 and symptom relief suggests a potential link between neural ablation and the local mucosal microenvironment. This investigation shows the feasibility of cytokine monitoring to further investigate the mechanisms of rhinitis treatment.