Comparative Outcomes of Posterior Nasal Nerve Ablation and Inferior Turbinate Radiofrequency During Septoplasty in Patients with Allergic Rhinitis: A Prospective Study.

BackgroundThe efficacy of adjunctive procedures targeting allergic rhinitis (AR) symptoms during septoplasty remains controversial. While radiofrequency ablation of the inferior turbinates (ITRA) is commonly performed, its impact on allergic symptoms beyond nasal obstruction is limited. Posterior nasal nerve ablation (PNNA) has recently gained attention as a promising alternative.ObjectiveTo compare the effects of PNNA and ITRA performed concurrently with septoplasty on allergic and obstructive nasal symptoms in patients with septal deviation and AR.MethodsThis prospective cohort study included 69 patients with septal deviation and AR who underwent septoplasty with either PNNA (n = 35) or ITRA (n = 34). Symptoms were assessed preoperatively and at 3 months postoperatively using the Mini-Rhinoconjunctivitis Quality of Life Questionnaire (MiniRQLQ), reflective Total Nasal Symptom Score (rTNSS), and Nasal Obstruction Symptom Evaluation (NOSE) scale. The rTNSS was divided into obstruction-related (rTNSS-A) and allergic (rTNSS-B) sub scores.ResultsBoth groups showed significant postoperative improvement in all parameters (p < 0.001). Compared with ITRA, the PNNA group demonstrated greater reductions in MiniRQLQ (mean changes = 36.97 ± 12.4 vs 32.00 ± 11.8; p = 0.025), rTNSS-B (median changes = 4.0 vs 2.0; p < 0.001), and rTNSS (median changes = 4.0 vs 2.5; p < 0.001). Changes in rTNSS-A and NOSE scores were comparable between groups (p > 0.05). No serious adverse events occurred; transient crusting was observed in 5 ITRA and 3 PNNA patients, and mild bleeding in 2 ITRA patients.ConclusionBoth techniques effectively improved nasal symptoms, but PNNA provided superior relief of allergic symptoms and quality-of-life gains, supporting its consideration as an adjunctive treatment in septoplasty patients with comorbid AR.