Posterior nasal neurectomy – long-term data shows tailing off of benefits but still improvement after three years
Reviewed by Joanna Stephens

It is well understood that allergic rhinitis has a very detrimental effect on quality of life for afflicted patients. This study looks at patients with allergic rhinitis but no other associated sinonasal or respiratory diagnoses. Patients with a history of dry eye were also excluded from the study. All patients were treated with posterior nasal nerve neurotomy under general anaesthetic by the same surgeon. All branches of the posterior nasal nerve were resected as far away from the sphenopalatine foramen as possible to prevent damage to the sphenopalatine ganglion. Outcome measures were improvement in rTNSS at three months, six months, one year, two years and three years postoperatively. Postoperative complications included nasal dryness, epistaxis, hyposmia, dry eye, headache and sensory disturbance of the palate or lips. Initially 213 subjects were recruited, however some were lost to follow-up, so a total of 154 patients were assessed. The results are fairly impressive in terms of a statistically significant reduction in nasal symptom scores from the first measurement at three months, though this effect diminished later, up to three years post treatment. This correlates well with previous studies too. So, whilst many of the benefits persisted, the results were not as impressive as time went by. However, this remains a very useful treatment for this common condition.

Three-year outcomes after posterior nasal neurectomy in perennial moderate and severe allergic rhinitis patients.
Zhang B, Wang J, Wang W, et al.
AM J RHINOL ALLERGY
2025;39(1):32–7.