Radiofrequency ablation of inferior turbinates for rhinitis medicamentosa: a systematic review and case series.

PURPOSE: Rhinitis medicamentosa (RM) affects up to 9% of patients seen in rhinology clinics and remains difficult to manage once topical decongestant dependence develops. Conservative measures often fail. Radiofrequency ablation (RFA) of the inferior turbinates offers a minimally invasive alternative that targets mucosal hypertrophy and may support withdrawal.

METHODS

A systematic review was conducted in accordance with PRISMA 2020 and prospectively registered with PROSPERO (CRD420251137740). Studies reporting outcomes of inferior turbinate RFA for RM were identified from MEDLINE, Embase, Scopus and Cochrane databases. Primary outcomes were decongestant cessation and change in validated symptom scores. In addition, a retrospective institutional case series of 25 consecutive patients treated with RFA was analysed.

RESULTS

Four studies met inclusion criteria (66 patients). All reported symptomatic improvement, with decongestant cessation in up to 100% of cases and minimal complications. In our series, 18 of 21 (85.7%) patients with follow-up discontinued decongestants, and mean SNOT-22 improved from 54.5 ± 19.0 to 35.0 ± 24.2 (p = 0.0008). No major complications occurred.

CONCLUSIONS

This is the first combined systematic review and case series evaluating RFA for RM. RFA is a safe, outpatient procedure associated with high rates of decongestant cessation and clinically meaningful symptom improvement. Its low complication profile supports its role as a low-risk outpatient option for selected patients with refractory RM in secondary care.