Blue-Laser Posterior Nasal Neurolysis via Dual Layer Nerve Modulation for Chronic Rhinitis.

OBJECTIVE

Chronic rhinitis (CR) may be allergic (AR), nonallergic (NAR), or mixed, and depending on the etiology and severity, patients experience various degrees of rhinorrhea, obstruction, itching, and sneezing. Chronic AR is estimated to impact over 26.3% of the people in Taiwan. Inferior turbinate reduction can improve nasal obstruction symptoms, and posterior nasal nerve neurolysis can reduce symptoms caused by neurogenic hypersecretion. Blue-laser posterior nasal neurolysis via dual-layer nerve modulation provides a precise operation for chronic AR.

METHODS

In this retrospective study, conducted at Shuang Ho Hospital in 2025, we compared the efficacy and safety of blue-laser inferior turbinate reduction (BITR) combined with blue-laser posterior nasal nerve neurolysis (BPN3). In total, 42 adult patients with CR who had not responded adequately to at least 3 months of drug therapy (≥ 3 months) were included. The primary outcomes were the 24-h reflective Total Nasal Symptoms Score (rTNSS) and the Nasal Obstruction Symptoms Evaluation (NOSE) scale score, which were compared and analyzed at the baseline, and 1 and 6 months postoperatively.

RESULTS

At 1 month, all patients exhibited significant improvements. Mean rTNSS had decreased from 7.9 ± 2.1 to 1.7 ± 1.6 (-78.5%) and NOSE scores improved from 69.3 ± 11.4 to 7.0 ± 6.5 (-89.9%). At 6 months, the mean rTNSS had decreased from 7.9 ± 2.1 to 1.9 ± 1.8 (-76.0%) and NOSE scores had improved from 69.3 ± 11.4 to 6.6 ± 5.3 (-92.0%). Overall, no serious complications occurred during the study period.

CONCLUSIONS

BPN3 combined with inferior turbinate reduction provides superior symptom relief, particularly for rhinorrhea, with excellent safety and tolerability. This dual layer nerve modulation operation offers a promising minimally invasive treatment for medication-refractory chronic AR.

LEVEL OF EVIDENCE: IV.