Houston Methodist-Led Trial Validates Next-Generation Radiofrequency Ablation for Chronic Rhinitis

A multicenter randomized controlled trial led by Houston Methodist researchers has demonstrated that impedance-controlled multipoint radiofrequency ablation significantly improves symptoms and quality of life for patients with chronic rhinitis — adding high-level evidence to a rapidly advancing treatment space.

Published in International Forum of Allergy & Rhinology, the study evaluated the NEUROMARK system, an impedance-guided device targeting the posterior nasal nerve (PNN), a key driver of chronic rhinitis symptoms.

In the prospective, single-blinded trial, 132 patients were randomized 2:1 to active treatment or a sham procedure. At 90 days, 73.3% of treated patients achieved at least a 30% reduction in Total Nasal Symptom Score, compared with 35% in the control group — confirming the therapy’s superiority.

“These were pretty impressive results for a randomized, sham-controlled trial,” said Dr. Omar Ahmed, a Houston Methodist otolaryngologist and study co-author.

Broad symptom and quality-of-life improvements

Beyond the primary endpoint, patients receiving treatment experienced significantly greater improvements in postnasal drip, cough, nasal obstruction and disease-specific quality-of-life measures. The therapy also produced measurable gains in depressive symptoms, as captured by PHQ-9 scores — highlighting the broader burden of chronic rhinitis.

For Dr. Mas Takashima, chair of Otolaryngology – Head & Neck Surgery at Houston Methodist, the findings reinforce a critical reframing of the disease.

“Patients can feel like they have a constant cold — coughing, clearing their throat, struggling to sleep or function day to day,” he said, noting the condition’s impact on productivity and mental health.

Dr. Ahmed added that treating rhinitis effectively extends well beyond symptom relief.

“When you improve the underlying condition, you see improvements in sleep, daily functioning and overall well-being,” said Dr. Ahmed.

A more precise approach to neuromodulation

The NEUROMARK system represents an evolution of PNN-targeting therapies, using real-time impedance feedback to modulate energy delivery. Unlike temperature-controlled devices, which limit heat, impedance-controlled systems continuously monitor tissue resistance and adjust energy in response.

“That feedback allows the device to respond to tissue changes in real time,” Dr. Takashima explained, describing impedance as a “smart” measure of how easily electrical current flows through tissue.

This approach may improve procedural consistency across patients with varying anatomy, an important step as office-based rhinitis interventions continue to expand.

Raising the bar with sham-controlled evidence

The study also underscores the importance of rigorous trial design in rhinology, where placebo effects can be substantial.

“In this field, you can see up to a 35% response even in sham procedures,” Dr. Takashima said. “Demonstrating superiority over that baseline is essential.”

Few PNN-targeting therapies have been evaluated in randomized, sham-controlled trials, making the current study a meaningful contribution to the evidence base.

A Houston Methodist-led field

Houston Methodist has been instrumental in advancing posterior nasal nerve therapies, helping define the anatomy, pathophysiology and clinical application of neuromodulation for chronic rhinitis. The institution’s researchers have authored a substantial portion of the peer-reviewed literature in this space and continue to lead multicenter trials evaluating emerging technologies.

This latest study further positions Houston Methodist at the forefront of a shift from symptomatic management to targeted, mechanism-based intervention — demonstrating that neuromodulation can deliver durable, system-wide benefits for a condition long dismissed as minor.

As additional durability data and comparative studies emerge, Houston Methodist investigators are helping shape not just incremental innovation, but the clinical framework that will define how chronic rhinitis is treated nationwide.