Chronic Rhinitis Treatment Shows Durable Results at Three-Year Mark

A Houston Methodist–led clinical trial is providing strong long-term evidence that a minimally invasive, office-based procedure can deliver sustained relief for patients with chronic rhinitis — a condition that remains notoriously difficult to manage with medications alone.

The study, published in the International Forum of Allergy and Rhinology, followed patients treated with temperature-controlled radiofrequency ablation (TCRFA) of the posterior nasal nerve and found significant, durable improvements in symptoms and quality of life after the one-time procedure.

Affecting millions of people, chronic rhinitis is driven in part by overactivity of the posterior nasal nerve, which regulates mucus production, congestion and other hallmark symptoms. While medication remains the first-line therapy, many patients continue to experience persistent rhinorrhea, nasal congestion, sneezing and postnasal drip.

“This is a patient population that often cycles through medications without achieving adequate relief,” said Dr. Mas Takashima, chair of Otolaryngology–Head & Neck Surgery at Houston Methodist. “Targeting the underlying neural pathway offers a fundamentally different therapeutic approach, interrupting the parasympathetic signaling that drives chronic symptoms.”

Sustained symptom improvement at three years

The multicenter, randomized controlled trial enrolled 104 patients initially, with 59 completing the three-year follow-up. Investigators found that symptom burden — measured by the reflective total nasal symptom score — improved by more than 57% from baseline, with mean scores dropping from 8.2 to 3.5, a statistically significant response.

Nearly 80% of patients met the threshold for clinically meaningful improvement at three years, a response rate that remained consistent with earlier follow-up intervals.

Importantly, the study showed that most of the clinical benefit occurred within the first year and was then maintained through three years, suggesting long-term durability after a single treatment.

“These findings demonstrate that a one-time, minimally invasive intervention can provide lasting symptom control,” said Dr. Takashima. “Because durability is a critical consideration for patients and clinicians weighing their options, we’ve committed to following these patients long-term.”

Beyond congestion: addressing overlooked symptoms

In addition to improvements in core nasal symptoms, the study found significant and sustained reductions in cough and postnasal drip — symptoms that are often underrecognized and undertreated by medication but highly burdensome for patients.

Cough scores were cut by nearly half, while postnasal drip scores declined by more than one point on a standardized severity scale, both with statistical significance.

The distribution of symptom severity also shifted meaningfully over time, with patients moving from moderate or severe symptoms at baseline to predominantly mild or no symptoms at three years.

“These are symptoms that can significantly impact sleep, daily functioning and overall quality of life,” Dr. Takashima noted, adding that their improvement reinforces the broader clinical relevance of the procedure beyond nasal drainage and congestion.

Meaningful quality-of-life gains

Quality-of-life outcomes mirrored the symptom improvements. Scores on the Mini Rhinoconjunctivitis Quality-of-Life Questionnaire improved by more than 50% from baseline and remained stable through three years.

More than three-quarters of patients achieved a clinically meaningful improvement in quality of life — a key benchmark in rhinitis research.

The findings align with previous Houston Methodist work highlighting the downstream impact of chronic rhinitis, including sleep disruption, reduced productivity and overall health burden. By addressing the neural drivers of disease, TCRF appears to offer a more durable solution than symptom-based medical therapy alone.

Reduced medication burden, strong safety profile

The study also suggests that the procedure may reduce reliance on medications. At three years, a substantial proportion of patients had either decreased or discontinued common therapies, including antihistamines, corticosteroid sprays and anticholinergics.

From a safety standpoint, no serious adverse events were reported over the three-year follow-up, and no new device- or procedure-related events occurred after the first year.

That safety profile stands in contrast to more invasive surgical options which can carry risks including dry eye and facial numbness.

“The ability to perform this procedure in an office setting under local anesthesia, with a low complication profile, is a significant advantage,” Dr. Takashima explained.

Shifting the treatment paradigm

Houston Methodist researchers have been at the forefront of advancing minimally invasive approaches to chronic rhinitis for several years, leading multiple earlier studies demonstrating short- and intermediate-term efficacy of TCRF technology. This latest analysis extends that evidence, reinforcing its role as a durable treatment option.

For clinicians, the findings underscore a growing shift toward office-based, mechanism-driven interventions. By directly targeting the posterior nasal nerve, the procedure addresses the pathophysiologic root of disease rather than simply managing symptoms — a distinction that may help reshape treatment algorithms for patients with refractory rhinitis.

While longer-term data and additional cost-effectiveness analyses are still needed, the three-year results provide compelling evidence that TCRF ablation can offer sustained, clinically meaningful relief for a condition that has long lacked durable solutions.