American Journal of Rhinology & Allergy最新文献

{"title":"Efficacy and Safety of Simultaneous Bilateral Nasal Cauterization in Pediatric Recurrent Anterior Epistaxis: A Prospective Randomized Controlled Trial.","authors":"Zhengcai Lou, Hailing Yang, Chaowei Zhao, Kanfeng Jin, Junzhi Sun, Mengyun Liu, Tian Lv, Weiwei Li","doi":"10.1177/19458924261437216","DOIUrl":"10.1177/19458924261437216","url":null,"abstract":"<p><p>ObjectiveWe compared the efficacy and safety of simultaneous bilateral silver nitrate cautery (SNC), bipolar electrocautery (BEC), and radiofrequency coagulation (RFC) for the treatment of pediatric bilateral recurrent anterior epistaxis (RAE).Materials and MethodsChildren with bilateral RAE were prospectively randomized to receive SNC (<i>n</i> = 40), BEC (<i>n</i> = 40), or RFC (<i>n</i> = 40). The primary outcome measures were successful hemostasis and re-bleeding at 4 weeks, 6 months, and 12 months. Secondary outcomes included the requirement for postoperative analgesia, visual analog scale (VAS) pain scores, and procedure-related complications.ResultsIn total, 212 nostrils of 106 patients were analyzed. The rates of successful hemostasis were 73.4%, 85.9%, and 97.1% in the SNC, BEC, and RFC groups, respectively (<i>P</i> < .01). At 4 weeks, the re-bleeding rates were 45.3%, 19.2%, and 2.9% in the SNC, BEC, and RFC groups, respectively (<i>P</i> < .01). At 6 months, re-bleeding occurred in 59.4% of SNC patients, 11.5% of BEC patients, and 0% of RFC patients (<i>P</i> < .001). At 12 months, the re-bleeding rates were 70.3%, 5.1%, and 0.0% in the SNC, BEC, and RFC groups, respectively (<i>P</i> < .001). Significant differences were observed in VAS scores for nasal crusting across the three groups at all follow-up points; however, no significant difference was detected between SNC and RFC. In contrast, septal perforation was observed in 5.1% of BEC patients, with mucosal necrosis in 6.4% of treated nostrils. In the RFC group, septal perforation developed in 2.9% of patients.ConclusionRFC demonstrated higher hemostatic success and lower recurrence of epistaxis compared with SNC and BEC in the treatment of bilateral RAE, while bilateral cross-cauterization with RFC should still be used with caution given the incidence of septal perforation. Additionally, stepwise cauterization with BEC (treating each side after healing of the opposite side) should be considered when managing pediatric bilateral RAE.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"394-401"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147621589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When Science Is Devoted to Patient-Centered Care in Rhinology.","authors":"Carlos D Pinheiro-Neto","doi":"10.1177/19458924261472060","DOIUrl":"https://doi.org/10.1177/19458924261472060","url":null,"abstract":"","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":"40 5","pages":"360-361"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148700560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bacterial Profile Stability of Middle Meatus Following Endoscopic Sinus Surgery: A Prospective Pilot Study.","authors":"Agnieszka Brociek-Piłczyńska, Małgorzata Stępińska, Marta Kwiatkowska, Dariusz Jurkiewicz, Elżbieta Trafny","doi":"10.1177/19458924261478895","DOIUrl":"https://doi.org/10.1177/19458924261478895","url":null,"abstract":"<p><p>PurposeThe aim of this study was to explore longitudinal changes in the middle meatal microbiome following endoscopic sinus surgery (ESS), accounting for relevant clinical variables in a group of patients with chronic rhinosinusitis (CRS).MethodsParticipants with CRS without nasal polyps and CRS with nasal polyps admitted for ESS were prospectively recruited. Endoscopically guided swabs were collected from 40 CRS patients at the time of surgery and during the postoperative visit, approximately 6 weeks after the surgery, from the region of the middle meatus. Bacterial communities were characterized using the 16S rRNA gene sequencing. Paired samples from 22 patients with CRS were included in the final analysis.ResultsThe overall microbial community composition, as reflected in alpha- and beta-diversity metrics and relative taxon abundances, remained generally stable after surgery. However, using advanced statistical methods, we identified subtle alterations in the microbiome. Postoperative beta diversity differed by occupational exposure and vitamin D status, whereas the Linear Model for Differential Abundance extended to a linear mixed-effect model detected modest taxonomic variation associated with age, allergy, body mass index, 25(OH)D, and extent of surgery.ConclusionDespite various factors known to modulate CRS and anatomical changes resulting from ESS, this pilot study found that the baseline microbiome structure of the middle meatus remained largely stable postoperatively. While ESS did not result in pronounced alterations of the overall bacterial landscape, selected covariates appeared to be associated with postsurgical microbiome shifts, highlighting the need for further investigation in larger cohorts.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"19458924261478895"},"PeriodicalIF":2.8,"publicationDate":"2026-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiofrequency Ablation Versus Cryoablation of the Posterior Nasal Nerve for Chronic Rhinitis: A Meta-Analysis and Systematic Review.","authors":"Tim A Mose, Prem C Patel, Jonathan A L Gelfond, Megana Challa, Matthew Y Liu, Matt Hayward, Philip G Chen","doi":"10.1177/19458924261480410","DOIUrl":"https://doi.org/10.1177/19458924261480410","url":null,"abstract":"<p><p>BackgroundPosterior nasal nerve (PNN) ablation has demonstrated efficacy for chronic rhinitis, although differences between radiofrequency ablation (RFA) and cryoablation (CA) remain unclear. This meta-analysis aims to indirectly compare long-term efficacy and safety between these modalities.MethodsA search for studies reporting efficacy or adverse events (AEs) of RFA or CA was conducted using 5 health science databases in January 2026. Meta-regression calculated change in the Total Nasal Symptom Score (TNSS), TNSS subscores, and the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ). Fisher's exact test compared overall and specific AE incidences.ResultsThis meta-analysis includes 12 studies and a total of 859 patients. Mean change for TNSS surpassed minimal clinically important threshold for both modalities at all follow-up time points. RFA demonstrated significantly greater improvement than CA at 30 days (0.63, 95% CI: 0.02-1.26, <i>P</i> = .045) until 365 days (0.60, 95% CI: 0.00-1.20, <i>P</i> = .049). TNSS subscores showed significant differences in favor of RFA over CA, for nasal itching (0.41, 95% CI: 0.23-0.58, <i>P</i> < .001) beginning at 30 days and sneezing (0.21, 95% CI: 0.03-0.39, <i>P</i> = .022) beginning at 90 days. RQLQ improvement at 90 days favored RFA over CA (0.19, 95% CI: 0.00-0.37, <i>P</i> = .047). RFA demonstrated lower AE incidence (5.3% vs 29.4%, <i>P</i> < .001). Specifically, CA had a higher incidence of headache and oral/palatal numbness events.ConclusionsBoth treatment modalities effectively reduce symptoms, although RFA demonstrated greater quality of life improvement and symptom relief, particularly for nasal itching and sneezing. While both modalities demonstrated low AE burden, RFA was generally associated with fewer AEs. Direct prospective comparisons are warranted.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"19458924261480410"},"PeriodicalIF":2.8,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148838881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence Synthesis of Probiotic Supplementation for Allergic Rhinitis in Adults: A Systematic Review and Network Meta-Analysis.","authors":"Thi Thu Hang Tran, Trung Dung Dao, Xuan Loc Doan","doi":"10.1177/19458924261461323","DOIUrl":"https://doi.org/10.1177/19458924261461323","url":null,"abstract":"<p><p>BackgroundProbiotics are increasingly explored as a potential adjunctive treatment for allergic rhinitis, a condition affecting approximately one in five adults worldwide. Despite distinctive age-related differences in gut microbiota composition, immunologic characteristics, and clinical profiles, no previous systematic review has comprehensively evaluated immunological and inflammatory markers, as well as the clinical efficacy and safety of probiotic supplementation exclusively in adult patients with allergic rhinitis. This study aimed to fill this evidence gap.MethodsAccordingly, eligible studies were identified by searching PubMed and Embase, supplemented by manual screening. After data extraction, a systematic review with trial sequential analysis and Bayesian network meta-analysis was performed.ResultsIn total, 68 RCTs from 63 publications were included, involving 4901 adult participants, with 55 outcomes extracted for analysis. The pooled results showed that probiotic supplementation significantly improved clinical symptom severity, including rhinorrhea (MD, -0.19; 95% CI, -0.28 to -0.10; P < 0.001), nasal itching (MD, -0.23; 95% CI, -0.34 to -0.11; P = 0.001), nasal congestion (MD, -0.18; 95% CI, -0.24 to -0.11; P < 0.001), sneezing (MD, -0.17; 95% CI, -0.27 to -0.06; P = 0.003), ocular itching (MD, -0.17; 95% CI, -0.28 to -0.06; P = 0.007), total nasal symptom severity (MD, -1.50; 95% CI, -2.33 to -0.66; P = 0.001), and overall quality of life (MD, -0.30; 95% CI, -0.46 to -0.13; P = 0.002). However, no significant effects were observed on immunological and inflammatory outcomes. Multi-strain formulations, <i>Bifidobacterium longum</i>, and <i>Bifidobacterium lactis</i> showed consistently high rankings across several outcomes; however, these rankings should be interpreted cautiously given the lack of direct head-to-head comparisons between probiotic formulations.ConclusionOverall, the study demonstrated that probiotic supplementation may provide small clinical benefits with a favorable safety profile in adults with allergic rhinitis, supporting the role of probiotic supplementation as an adjunct rather than a replacement for standard treatment.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"19458924261461323"},"PeriodicalIF":2.8,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148838934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AI-derived Histopathological Signatures Are Associated With Response to Mepolizumab in Chronic Rhinosinusitis With Nasal Polyps.","authors":"Jens Tidemandsen, Simon Høj, Thomas Hl Jensen, Martin Stampe, Anne Sophie Homøe, Marie Høxbro, Kasper Aanæs, Sarah Charabi, Vibeke Backer","doi":"10.1177/19458924261469379","DOIUrl":"https://doi.org/10.1177/19458924261469379","url":null,"abstract":"<p><p>BackgroundChronic rhinosinusitis with nasal polyps (CRSwNP) is a heterogeneous inflammatory disease with variable response to biologic therapy. Tissue-based predictors of treatment response are limited, and conventional eosinophil-focused histopathology has shown inconsistent predictive value.ObjectiveTo assess whether artificial intelligence (AI)-derived baseline histopathology of nasal polyps contains information associated with clinical response to mepolizumab in CRSwNP.MethodsThis hypothesis-generating substudy included patients with severe CRSwNP enrolled in a randomized controlled trial. Baseline biopsies were analysed using an AI-driven spatial histopathology pipeline extracting 84 morphological features per cell. Features were evaluated in eosinophil-only, noneosinophil, and all-cell configurations. Treatment response at 6 and 12 months was defined using EUFOREA criteria. Linear discriminant analysis and partial least squares regression were applied.ResultsFifty-eight patients were included. At 12 months, the eosinophil-only model showed limited discrimination (AUC ≈ 0.43), the noneosinophil model moderate discrimination (AUC ≈ 0.62), and the all-cell model the highest performance (AUC ≈ 0.75). At 6 months, all models showed limited discrimination (AUC ≈ 0.49). For continuous outcomes, noneosinophil models explained the greatest variance (R² up to ≈ 0.34).ConclusionAI-derived baseline histopathology contains information associated with clinical response to mepolizumab in CRSwNP. Models incorporating the broader tissue microenvironment outperformed eosinophil-focused approaches, supporting the potential of computational pathology for pretreatment stratification of biologic therapy in CRSwNP.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"19458924261469379"},"PeriodicalIF":2.8,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"VCAM-1 Serves as a Biomarker for Discriminating Eosinophilic CRSwNP and Regulates IL-13-Induced Vascular Remodeling.","authors":"Shenghao Cheng, Lai Meng, Shaobing Xie, Hua Zhang, Junyi Zhang, Fengjun Wang, Benjian Zhang, Zhihai Xie, Weihong Jiang","doi":"10.1177/19458924261478368","DOIUrl":"https://doi.org/10.1177/19458924261478368","url":null,"abstract":"<p><p>BackgroundChronic rhinosinusitis with nasal polyps (CRSwNP) is a highly heterogeneous inflammatory disease with distinct inflammatory endotypes. This study aimed to identify reliable biomarkers for precise discrimination of eosinophilic CRSwNP (eCRSwNP), and to explore their potential roles in the pathological progression of CRSwNP.MethodsA total of 107 patients with CRS (including 22 CRSsNP and 85 CRSwNP) and 40 healthy controls were enrolled. Differentially expressed proteins related to eCRSwNP were screened via protein microarray combined with the random forest algorithm. The expression of candidate proteins was validated in clinical tissues and serum. Correlation analysis and receiver operating characteristic (ROC) curves were applied to evaluate the association of candidate molecules with eosinophilic inflammation and disease prognosis. Hematoxylin and eosin (HE) staining was performed to assess histopathological changes. Human umbilical vein endothelial cells (HUVECs) were used to explore the regulatory effects of IL-13 on VCAM-1 expression and angiogenesis. siRNA knockdown and tube formation assays were further adopted to verify the functional mechanism.ResultsProtein chip and machine learning analysis identified VCAM-1 as a major molecule associated with CRSwNP endotype. VCAM-1 expression was significantly elevated in both tissue and serum of CRSwNP patients, particularly in eosinophil CRSwNP (eCRSwNP) group. HE staining showed a significant increase in neovascularization in the CRSwNP group compared to the control and CRSsNP groups, especially in the eCRSwNP. Multiplex immunofluorescence revealed increased VCAM-1/CD31 co-expression in vascular regions of eCRSwNP tissues. In vitro, IL-13 induced VCAM-1 expression in HUVECs in a time and dose-dependent manner, while VCAM-1 knockdown reduced CD31 levels and impaired angiogenesis, indicating its functional role in pathological neovascularization.ConclusionVCAM-1 is significantly upregulated in eCRSwNP and closely correlated with eosinophilic inflammation. VCAM-1 may facilitate eosinophil infiltration by participating in IL-13-mediated angiogenesis and vascular remodeling in eCRSwNP.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"19458924261478368"},"PeriodicalIF":2.8,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Glycemic Status and Antidiabetic Agents on the Recurrence of Chronic Rhinosinusitis with Nasal Polyps: A Multicenter Study.","authors":"Yeon Hee Im, Chan-Soon Park, Dong-Hyun Kim, Se Hwan Hwang, Dong Chang Lee, Jae Yoon Lee","doi":"10.1177/19458924261476795","DOIUrl":"https://doi.org/10.1177/19458924261476795","url":null,"abstract":"<p><p>BackgroundAlthough several reports suggest that antidiabetic agents may exert anti-inflammatory effects, the influence of glycemic status and antidiabetic agents on chronic rhinosinusitis remains unexplored.ObjectiveThis study aimed to assess the impact of glycemic status and antidiabetic agents on postoperative recurrence of chronic rhinosinusitis with nasal polyps (CRSwNP).MethodsWe conducted a retrospective review of records from six medical centers, including patients who underwent endoscopic sinus surgery for bilateral CRSwNP, with a minimum follow-up duration of 3 years. Patients were stratified into normoglycemic patients, dysglycemic patients without antidiabetic agent use, and dysglycemic patients receiving antidiabetic agents. Clinical characteristics were compared both across these groups and between patients with and without postoperative rhinosinusitis recurrence. Binary logistic regression analysis was used to identify independent predictors of recurrence and analyze medication-specific effects. Cumulative hazard of rhinosinusitis recurrence according to perioperative glycemic status and antidiabetic agent use were analyzed.ResultsA total of 503 patients were analyzed. During the postoperative follow-up period, rhinosinusitis recurrence occurred least frequently among dysglycemic patients receiving antidiabetic agents (<i>P</i> = .008). Antidiabetic agent users had a significantly reduced cumulative hazard of recurrence compared with nonusers (<i>P</i> < .001). Consistently, the proportion of antidiabetic agent users was significantly higher in the nonrecurrence group than in the recurrence group (<i>P</i> = 0.008). In contrast, perioperative fasting blood glucose and glycated hemoglobin levels were not significantly associated with postoperative recurrence. Binary logistic regression analysis identified younger age, absence of antidiabetic agent use, and poorer preoperative olfactory identification scores as independent predictors of recurrence.ConclusionPerioperative antidiabetic agent use was associated with a significantly reduced risk of postoperative recurrence in CRSwNP patients. The lack of significant association between glycemic status and recurrence further suggests that antidiabetic agents themselves, distinct from glycemic control, may exert a modulatory effect on the CRSwNP disease course.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"19458924261476795"},"PeriodicalIF":2.8,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148758010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Biologic Switching in Chronic Rhinosinusitis With Nasal Polyps.","authors":"Beverly J Fu, Itzel Jimenez, Michael T Chang, Zara M Patel, Jayakar V Nayak, Peter H Hwang, Noel Ayoub","doi":"10.1177/19458924261477466","DOIUrl":"https://doi.org/10.1177/19458924261477466","url":null,"abstract":"<p><p>Objective(s)Biologic therapies have expanded treatment options for chronic rhinosinusitis with nasal polyps (CRSwNP), but many patients have inadequate response to their initial biologic and requiring switching. Outcomes after switching, particularly patient-reported measures, remain poorly characterized. We aimed to identify predictors and outcomes of biologic switching in adults with CRSwNP.MethodsWe retrospectively reviewed adults initiating biologics for CRSwNP between 2009 and 2025 at a tertiary center. Demographic, clinical, radiographic, histopathologic, and Sinonasal Outcome Test-22 (SNOT-22) data were collected. Predictors and outcomes of biologic change were analyzed.ResultsAmong 400 patients, 70 (18%) switched biologics after a mean of 38 months. All patients were diagnosed with CRSwNP, which was the primary indication in 61%. Baseline demographics were comparable between groups. Switching was more common with omalizumab (39%) and mepolizumab (40%) than dupilumab (5%) (<i>P</i> < .01). Most from omalizumab or mepolizumab transitioned to dupilumab for inadequate CRSwNP control (42% and 50%), whereas dupilumab was typically discontinued due to adverse effects (39%). Compared with nonswitchers, switchers more often exhibited radiologic air-fluid levels (<i>P</i> < .01), asthma (<i>P</i> < .01), aspirin-exacerbated respiratory disease (<i>P</i> = .01), and chronic obstructive pulmonary disease (<i>P</i> = .04). Baseline SNOT-22 scores were similar (<i>P</i> = .20), but higher for switchers at 6 months (<i>P</i> < .01). After switching, 70.6% of patients improved, with a mean SNOT-22 reduction of 9.4 points (<i>P</i> = .02), approaching outcomes of nonswitchers.ConclusionPatients who switch biologics for CRSwNP typically transition to dupilumab due to inadequate symptom control. Biologic switching appears to be an effective strategy for refractory CRSwNP, leading to outcomes comparable to those who respond to initial therapy, despite greater baseline severity.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"19458924261477466"},"PeriodicalIF":2.8,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148766562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiofrequency Ablation of the Intraturbinate Posterior Nasal Nerve Versus Medical Treatment for Chronic Rhinitis.","authors":"Yi-Li Hwang, Jyun-Yi Liao, Han-Lo Teng, Ting-Yu Shih, Chien-Yu Huang","doi":"10.1177/19458924261478358","DOIUrl":"https://doi.org/10.1177/19458924261478358","url":null,"abstract":"<p><p>BackgroundMedical treatment has been the mainstay of chronic rhinitis management. Meanwhile, innovative minimally invasive nasal surgery has shown promising results. The therapeutic outcomes of these surgical interventions compared with medical treatment in chronic rhinitis have not been discussed previously.ObjectiveThis study aimed to evaluate the efficacy of radiofrequency ablation of the inferior turbinate of the intraturbinate segment of the posterior nasal nerve (RAPN) in comparison with intranasal corticosteroid spray (INCS) plus oral antihistamines for the treatment of chronic rhinitis.MethodsA retrospective cohort study was conducted on patients with chronic rhinitis who had an inadequate response to medication. Inclusion criteria included a 24-h Reflective Total Nasal Symptom Score (rTNSS) ≥4 and a rhinorrhea score ≥1. Patients with prior nasal surgeries, caudal septal deviation, or acute/chronic rhinosinusitis were excluded. The primary endpoint was the change in 24-h rTNSS and Nasal Obstruction Symptom Evaluation (NOSE) scores at the 3-month follow-up.ResultsA total of 64 patients were included: 44 received RAPN, and 20 received INCS. Baseline rTNSS was 7.3 ± 2.1 for RAPN and 6.9 ± 2.3 for INCS (<i>p</i> = .497). Both groups showed significant improvement in rTNSS and NOSE scores at 1 and 3 months (<i>p</i> < .001). However, the RAPN group demonstrated significantly greater improvement than the INCS group at 1 to 3 months of follow-up (<i>p</i> = .001). Subscore analysis revealed that rhinorrhea (at 1 and 3 months) and sneezing (at 1 month) did not differ significantly between groups. One case of postoperative anterior epistaxis was noted in the RAPN group.ConclusionsBoth INCS and RAPN are highly effective in alleviating chronic rhinitis symptoms. Although RAPN does not establish definitive superiority over medical therapy across all neurogenic domains, it provides comparable, sustained symptom control with the distinct advantage of drug-free maintenance, offering a valuable therapeutic alternative.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"19458924261478358"},"PeriodicalIF":2.8,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148761291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}