Rhinorrhea Recurrence After Posterior Nasal Nerve Cryoablation: A Multicenter Cohort Study.

BACKGROUND

Posterior nasal nerve (PNN) cryoablation improves chronic rhinitis (CR) symptoms in 70-80% of cases, including clear thin rhinorrhea (CTR). This study's purpose was to determine time to and degree of CTR recurrence following cryoablation.

METHODS

A multicenter retrospective cohort study was conducted on patients who underwent PNN cryoablation to treat CR-related CTR refractory to ipratropium bromide nasal spray (IBNS). Cryoablation was applied along middle meatal posterolateral walls. Demographic and clinical data were collected at clinic visits or by phone surveys. Patients were followed for either 12 months minimum, or until CTR recurrence. Primary outcome measures were time to and degree of CTR improvement and recurrence based on patient-reported runny nose scores (Likert scale, 0-5). Additionally, patients were asked whether their recurrent CTR was bothersome enough to require treatment, and their preference for subsequent treatments.

RESULTS

Of 74 CR patients, mean age was 58 years, and 53% were female. Regarding CR subtypes, 74% were nonallergic, 22% mixed, and 4% allergic. Additionally, 78% were IBNS responders. Overall, 62 of 74 (84%) initially improved. Of 60 patients with adequate follow-up for recurrence (mean 31.6 months), 57 (95%) recurred to some degree at a mean 5 months post-treatment. Of those who recurred, 37 (65%) recurred completely to preoperative RNSs, and 11 (19%) achieved 20-25% RNS reduction. Almost 90% of those with recurrent CTR were bothered enough to desire further treatment.

CONCLUSION

PNN cryoablation led to CTR improvement in 84% of CR patients, with nearly 90% of patients developing bothersome recurrent CTR by about 5 months post-treatment.

LEVEL OF EVIDENCE: 4 Laryngoscope, 135:1928-1934, 2025.