Postnasal drip and chronic cough in patients with chronic rhinitis treated with temperature-controlled radiofrequency neurolysis

Daniel Gorelik, Jumah G. Ahmad, Samuel E. Razmi, Masayoshi Takashima, Yin Yiu, Apurva Thekdi, Murugappan Ramanathan, Aatin K. Dhanda, Michael T. Yim, Omar G. Ahmed

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

OBJECTIVE: To evaluate the contribution of postnasal drip (PND) and chronic cough (CC) to symptoms of patients with chronic rhinitis treated with temperature-controlled radiofrequency (TCRF) neurolysis of the posterior nasal nerve (PNN), and correlate PND and CC scores with components of the reflective total nasal symptom score (rTNSS).

METHODS: Pooled data from three prospective studies: two single-arm studies and the index active treatment arm of a randomized controlled trial. Adult patients with baseline rTNSS ≥6 were treated with TCRF neurolysis at nonoverlapping regions of the PNN. PND and CC symptoms were evaluated on a 0 (none) to 3 (severe) scale.

RESULTS: Data from 228 patients (57.9% women, 42.1% men) were included. The mean baseline rTNSS was 8.1 (95% confidence interval [CI], 7.8-8.3), which decreased to 3.2 (95% CI, 2.9-3.5) at 6 months. At baseline, 97.4% of patients had PND and 80.3% had CC. Median baseline PND and CC symptom scores were 3 (interquartile range [IQR], 2-3) and 2 (IQR, 1-2), respectively. At 6 months, this decreased to 1 (IQR, 0-2) and 0 (IQR, 0-1), respectively, showing significant improvement from baseline (both p < 0.001). Spearman correlation coefficients with components of rTNSS (rhinorrhea, congestion, itching, sneezing) were 0.16 to 0.22 for CC and 0.19 to 0.46 for PND, indicating only a weak to moderate correlation.

CONCLUSION: PND and CC contribute to the symptomatology of chronic rhinitis and are significantly improved after TCRF neurolysis of the PNN. The inclusion of PND and CC symptoms in a chronic rhinitis assessment instrument could provide important additional information for the characterization of the disease state and outcomes after any therapeutic treatment.

Original languageEnglish (US)
Pages (from-to)621-629
Number of pages9
JournalInternational Forum of Allergy and Rhinology
Volume14
Issue number3
DOIs
StatePublished - Mar 2024

Keywords

  • chronic cough
  • chronic rhinitis
  • posterior nasal nerve
  • postnasal drip
  • rTNSS
  • temperature-controlled radiofrequency neurolysis
  • Chronic Cough
  • Temperature
  • Prospective Studies
  • Rhinitis/drug therapy
  • Humans
  • Male
  • Nasal Mucosa
  • Randomized Controlled Trials as Topic
  • Rhinorrhea
  • Cough/therapy
  • Adult
  • Female

ASJC Scopus subject areas

  • Immunology and Allergy
  • Otorhinolaryngology

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