Three-year study gives hope for patients with chronic rhinitis

Mas Takashima, MD, FACS

Mas Takashima, MD, FACS, chairman of the Department of Otolaryngology – Head and Neck Surgery at Houston Methodist, along with a team of eight other experts from multiple institutions across the nation, recently crossed the three-year threshold for proving successful outcomes with temperature-controlled radiofrequency (TCRF) ablation of the posterior nasal nerve in patients with chronic rhinitis.

"With this longer study, we’re seeing an exciting shift in our neuromodulation and airway disease management," Dr. Takashima said. “This multicenter, single-blinded, randomized controlled trial with a sham control arm is the longest study yet.” Chronic rhinitis is a significant global health problem costing billions of dollars each year in direct and indirect costs. It is a persistent inflammation of the nasal mucous membranes, causing a runny nose, nasal congestion, sneezing, and postnasal drip. It impacts quality of life, both physically and emotionally, and sufferers experience impairment in concentration, cognitive ability, learning, and judgment.

A total of 104 patients underwent TCRF at 16 centers across the United States when the study started three years ago. The treatment itself is minimally invasive and performed in an office setting. The radiofrequency device has a setting that will not let temperatures go higher than 60 degrees Celsius or 140 degrees Fahrenheit. Treatments are administered to up to five nonoverlapping positions in the posterior nasal nerve (PNN). Treatment targets areas of the posterior middle meatus and posterior portion of the inferior turbinate. “We’ve followed these patients from the get-go. We’ve done reports after one year, two years and now three years,” Dr. Takashima said. The three-year study was published in March 2025 in the International Forum of Allergy and Rhinology.

80%

Of the 59 patients who continued to participate in the three-year study, about 80 percent said they had benefited from the procedure.

“The results that we saw were really good and it’s a solid study. We’ve seen continued improvement in virtually all of the patients’ symptoms,” Dr. Takashima added. Results showed a shift from moderate to severe symptoms before the procedure to mild to no symptoms at follow-up. Patients reported sustained reductions in symptoms with meaningful improvements in quality of life over three years. These findings contribute to evidence supporting the safety and efficacy of TCRF PNN ablation for reducing rhinitis symptoms. More invasive treatments carry significant risks such as dry eye and palatal numbness -- complications that have not been observed with TCRF ablation. The most frequent complications—nasal dryness, transient discomfort, crusting, and minor nosebleeds—were mild and resolved on their own. TCRF can be performed in-office under local anesthesia, resulting in fewer adverse events and no serious adverse events compared to more invasive surgeries. Challenges in follow-up studies include patient attrition; however, most nonparticipants had previously responded well to treatment.