Chronic rhinitis is a condition characterized by persistent inflammation of the nasal passages. It affects millions of people worldwide, causing bothersome symptoms such as nasal congestion, sneezing, itching, and runny nose. While various treatment options are available for chronic rhinitis, one emerging therapeutic approach is posterior nasal nerve ablation. This article aims to comprehensively understand posterior nasal nerve ablation and its role in managing chronic rhinitis.

Understanding Chronic Rhinitis

Chronic rhinitis is more than just a runny nose. It is a chronic inflammatory condition that affects the lining of the nasal passages. The symptoms can be persistent and significantly impact the quality of life of affected individuals.


While many people may experience occasional rhinitis symptoms due to allergies or colds, chronic rhinitis is different. It is a long-term condition that can last for months or even years.

Symptoms and Diagnosis of Chronic Rhinitis

The symptoms of chronic rhinitis can vary from person to person but often include nasal congestion, post-nasal drip, sneezing, itching, and a runny nose. The symptoms may be mild and manageable for some individuals, while for others, they can be severe and debilitating.


Diagnosis of chronic rhinitis involves a thorough evaluation by a healthcare professional, including a medical history review, physical examination, and possibly additional tests such as allergy testing. It is important to accurately diagnose chronic rhinitis to determine the underlying cause and develop an appropriate treatment plan.

Impact on Quality of Life

Living with chronic rhinitis can significantly impact an individual’s quality of life. The persistent symptoms may interfere with daily activities, disrupt sleep, affect concentration and productivity, and cause emotional distress. Imagine waking up every morning with a stuffy nose, struggling to breathe properly throughout the day, and constantly dealing with a runny nose. These symptoms can make it challenging to focus at work or school, enjoy social activities, and get a good night’s sleep.


Furthermore, chronic rhinitis can have a significant impact on mental health. The constant discomfort and frustration of dealing with persistent symptoms can lead to feelings of anxiety, depression, and isolation. It is not uncommon for individuals with chronic rhinitis to experience a decreased overall well-being and a diminished quality of life.


Managing chronic rhinitis is essential to improve the quality of life for those affected. Treatment options may include medications such as antihistamines, nasal sprays, and decongestants. In some cases, allergen immunotherapy or surgical interventions may be recommended. It is important for individuals with chronic rhinitis to work closely with their healthcare providers to find the most effective treatment approach for their specific needs.


In conclusion, chronic rhinitis is a chronic inflammatory condition that affects the nasal passages and can significantly impact an individual’s quality of life. Understanding the symptoms, seeking a proper diagnosis, and exploring appropriate treatment options are crucial steps in managing this condition and improving overall well-being.

The Role of the Posterior Nasal Nerve in Rhinitis

The posterior nasal nerve plays a significant role in the development and persistence of chronic rhinitis. Understanding its anatomy and function can help explain why posterior nasal nerve ablation has emerged as a potential treatment option.

Anatomy and Function of the Posterior Nasal Nerve

Within the nasal cavity, the posterior nasal nerve plays a crucial role in detecting and transmitting sensory information related to smell, temperature, humidity, and irritants. It acts as a vital link between the nasal passages and the brain, ensuring that we can perceive and interpret the world around us through our sense of smell.


Moreover, the posterior nasal nerve also contributes to the regulation of nasal airflow and the maintenance of nasal mucosal integrity. It helps to control the dilation and constriction of blood vessels within the nasal passages, ensuring proper blood flow and oxygenation to the delicate nasal tissues.

How the Posterior Nasal Nerve Contributes to Rhinitis

The hyperactivity of the posterior nasal nerve in chronic rhinitis leads to increased release of neuropeptides and the recruitment of inflammatory cells in the nasal passages. This neurogenic inflammation perpetuates the cycle of inflammation, causing persistent nasal congestion, itching, and other troublesome symptoms.


When the posterior nasal nerve becomes hyperactive, it sends excessive signals to the brain, triggering an exaggerated response from the immune system. This response releases various inflammatory mediators, such as histamine, cytokines, and leukotrienes, which further exacerbate nasal inflammation.


The hyperactive posterior nasal nerve can also disrupt the delicate balance of the autonomic nervous system within the nasal mucosa. This imbalance can result in an overproduction of mucus, leading to nasal congestion and constant stuffiness.


Targeting the posterior nasal nerve has become a treatment strategy to break this cycle and offer relief to individuals suffering from chronic rhinitis. By selectively ablating or modulating the activity of the posterior nasal nerve, healthcare professionals aim to reduce hyperactivity and subsequent inflammation, thereby alleviating the bothersome symptoms associated with chronic rhinitis.


Various techniques can be employed to target the posterior nasal nerve, including radiofrequency ablation, cryotherapy, and chemical neurolysis. These procedures aim to disrupt the abnormal nerve signals and restore a more balanced and controlled function of the posterior nasal nerve.


While treating chronic rhinitis through posterior nasal nerve ablation is still relatively new, it holds promise as a potential therapeutic option for individuals who have not responded well to traditional treatments. Dr. Atkins performed a pivotal study on cryoablation of the posterior nasal nerve in 2015. Those patients are still doing fine. It was a small sample size and is not indicative that all patients will have lasting improvement, but this article was written in 2023, so with eight years of follow-up, the patients are still doing well.

What is Posterior Nasal Nerve Ablation?

When conservative treatments fail to provide adequate relief, posterior nasal nerve ablation can be considered as an alternative option. This procedure targets the underlying cause of chronic rhinitis by interrupting excessive nerve activity, thus providing long-term relief from the bothersome symptoms.

The Procedure Explained

During posterior nasal nerve ablation, a specialized instrument is used to apply controlled radiofrequency energy or cryotherapy to the posterior nasal nerve. This energy disrupts the nerve’s hyperactivity while minimizing damage to the surrounding tissues. The procedure is typically performed in an outpatient setting under local anesthesia or IV sedation, ensuring a comfortable experience for the patient.


The healthcare professional delivers the radiofrequency energy to the nerve, effectively interrupting its abnormal activity. The duration of the procedure may vary depending on the individual’s specific condition, but it is generally completed within a relatively short period of time.


Most individuals can resume their normal activities shortly after the procedure, although some may experience mild discomfort, which typically resolves within a few days.

Rhinaer device in place treating left posterior nasal nerve.

Rhinaer device in place treating left posterior nasal nerve

Two lesions on the left made by the Rhinaer device over the posterior nasal nerve.

endoscopic view of posterior nasal nerve after treatment with rhinaer

Risks and Benefits

As with any medical procedure, posterior nasal nerve ablation carries potential risks and benefits. It is important for individuals considering this treatment option to have a comprehensive understanding of both aspects.


The risks associated with posterior nasal nerve ablation are generally minimal. Some individuals may experience minor discomfort, which can be managed with over-the-counter pain relievers.


While the procedure is designed to minimize damage to surrounding tissues, there is a small risk of potential damage to nearby structures. Though extremely rare, a severe nosebleed is the worst complication.


On the other hand, the benefits of posterior nasal nerve ablation can be life-changing for individuals with chronic rhinitis. By disrupting the hyperactivity of the posterior nasal nerve, this procedure offers the potential for long-term symptom relief and improved quality of life. Many patients who have undergone posterior nasal nerve ablation report a significant reduction in nasal congestion, sneezing, and other bothersome symptoms, allowing them to breathe more freely and comfortably.


It is crucial to discuss the risks and benefits of posterior nasal nerve ablation with a healthcare professional who specializes in this procedure. They can provide personalized guidance and help determine if this treatment option is right for each individual’s unique situation.

Who is a Candidate for Posterior Nasal Nerve Ablation?

Not everyone with chronic rhinitis is suitable for posterior nasal nerve ablation. An evaluation by a healthcare professional is necessary to determine eligibility and evaluate potential benefits.

Evaluating Patient Suitability

Patient suitability for posterior nasal nerve ablation depends on various factors, such as the severity and duration of symptoms, the response to previous treatments, and any underlying medical conditions. A comprehensive evaluation will help identify individuals who may benefit most from this procedure.

Preoperative Considerations

Before undergoing posterior nasal nerve ablation, discussing any concerns, expectations, and potential alternatives with a healthcare professional is important. Additionally, it is crucial to provide a detailed medical history and inform the healthcare team of any medications, allergies, or previous surgeries.

Postoperative Care and Recovery

After undergoing posterior nasal nerve ablation, proper postoperative care and recovery are crucial in optimizing outcomes and minimizing complications. Understanding what to expect and adhering to the recommended guidelines will help ensure a smooth recovery.

What to Expect After Surgery

Following the procedure, some individuals may experience mild discomfort and temporary changes in sensation. These symptoms are generally transient and resolve within a few days. It is essential to stay well-hydrated, avoid strenuous activities, and follow any specific instructions the healthcare team provides.

Long-Term Outcomes and Prognosis

The long-term outcomes of posterior nasal nerve ablation for chronic rhinitis have shown promise. Many individuals experience a significant reduction in symptoms and improved quality of life. However, individual responses may vary, and it is important to continue working closely with a healthcare professional to monitor symptoms and make any necessary adjustments to the treatment plan.


In conclusion, posterior nasal nerve ablation is an emerging treatment option for individuals with chronic rhinitis. By disrupting the hyperactivity of the posterior nasal nerve, this minimally invasive procedure aims to provide long-term relief from bothersome symptoms and improve quality of life. While not suitable for everyone, posterior nasal nerve ablation offers a promising alternative for individuals who have not responded adequately to conservative treatments. If you are considering this procedure, consult a healthcare professional to determine if it is the right option.


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