Blue laser turbinate reduction with vs. without posterior nasal neurolysis for refractory rhinitis: a retrospective comparative study.

BACKGROUND

Chronic rhinitis that does not respond well to drug therapy remains a major challenge in clinical treatment. Inferior turbinate reduction can improve nasal obstruction symptoms, while posterior nasal nerve (PNN) ablation can reduce symptoms caused by neurogenic hypersecretion. Blue laser technology provides precise tissue coagulation and minimizes intraoperative bleeding.

METHODS

This retrospective comparative study, conducted at Shuang Ho Hospital between 2024 and 2025, aimed to compare the efficacy and safety of blue laser inferior turbinate reduction (BITR) combined with blue laser posterior nasal nerve neurolysis (BPN3) versus BITR alone. A total of Ninety-nine adult patients with chronic rhinitis who had not responded adequately to at least three months of drug therapy (≥ 3 months) were included. Among them, forty-eight patients received BITR combined with BPN3, and fifty-one patients received BITR only. The primary endpoints were the 24-hour reflective total nasal symptoms score (rTNSS) and the nasal obstruction symptoms evaluation scale (NOSE) score, which were compared and analyzed at baseline, 1 month and 6 months postoperatively.

RESULTS

At 6 months post-surgery, the mean Responsive Total Nasal Symptom Score (rTNSS) decreased by 77.6% in the BITR combined with BPN3 group (from 7.6 ± 1.9 to 1.7 ± 1.6), while the BITR alone group saw a 48% decrease (from 7.5 ± 1.6 to 3.9 ± 1.7), with a statistically significant difference between the two groups (p < 0.05). The Nasal Obstruction Symptom Assessment Scale (NOSE) scores improved by 91.9% and 85.5%, respectively, with a statistically significant difference between the two groups (p < 0.05). Overall, no serious complications occurred during the study period.

CONCLUSION

Blue laser posterior nasal nerve neurolysis combined with inferior turbinate reduction provides superior symptom relief compared with BITR alone, particularly for rhinorrhea, with excellent safety and tolerability. This dual-target approach offers a promising minimally invasive treatment for medication-refractory chronic rhinitis.