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: Seventeen patients were enrolled with 15 patients undergoing the treatment. The procedure was well tolerated with no major adverse events. The rTNSS improved from a median of 7.5 to 4 at 12 weeks ( P < .01). Median NOSE scores improved from 52.5 to 17.5 at week 12 ( P < .05). Minimal clinically important differences (MCID) were achieved by 67% of patients for rTNSS and 50% for NOSE. There were no significant changes in PNIF. Patient-level change in IL-10 was significantly associated with improvement in NOSE score ( r = −.70, P = .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.
Allen et al. (2026) studied this question.