Chronic rhinitis is a common condition characterized by persistent inflammation of the nasal lining, leading to symptoms like a runny nose and nasal congestion. While various treatment options are available, posterior nasal nerve ablation, a special type of sinus surgery in Pasadena, has emerged as a promising solution for individuals suffering from chronic rhinitis.

This minimally invasive procedure involves targeting specific nerves in the nasal cavity that contribute to the symptoms of chronic rhinitis. By selectively ablating these nerves, the procedure aims to reduce the overactive nerve signals that trigger inflammation and mucus production.

Understanding Chronic Rhinitis and Posterior Nasal Nerve Ablation

Chronic rhinitis can be triggered by various factors, including allergies and non-allergic irritants. Allergic rhinitis is caused by an allergic reaction to substances like pollen, dust mites, or pet dander. Non-allergic rhinitis, on the other hand, can be triggered by factors such as hormonal changes, medications, or environmental irritants.

Posterior nasal nerve ablation works by targeting specific nerves in the nasal cavity that contribute to the symptoms of chronic rhinitis. By selectively ablating these nerves, the procedure aims to reduce the overactive nerve signals that trigger inflammation and mucus production.

Two common methods used in posterior nasal nerve ablation are radiofrequency ablation and cryotherapy.

  • Radiofrequency ablation uses heat energy to damage the nerve tissue.
  • Cryotherapy utilizes cold temperatures to freeze and destroy the nerve tissue.

Who is a Candidate for Posterior Nasal Nerve Ablation?

Posterior nasal nerve ablation is typically considered for individuals who have chronic rhinitis that’s unresponsive to traditional treatments such as medications or allergy immunotherapy.

To determine if you are a suitable candidate for this procedure, you will need to consult with an ENT. The ENT doctor will conduct a thorough evaluation, including a physical examination and a review of your medical history, to assess the severity of your symptoms and identify any underlying causes of your chronic rhinitis.

While posterior nasal nerve ablation is generally a safe and effective procedure, there are certain contraindications that may make it unsuitable for some individuals. These contraindications may include:

  • Severe nasal structural abnormalities: Conditions such as deviated septum or nasal polyps may need to be addressed before considering ablation.
  • Active nasal infection: It is important to treat any active infection before undergoing the procedure.
  • Uncontrolled medical conditions: Individuals with uncontrolled medical conditions, such as high blood pressure or diabetes, may need additional evaluation and management before proceeding with ablation.

Your ENT specialist will be able to discuss the specific risks and benefits of posterior nasal nerve ablation and determine if it is an appropriate treatment option for your individual situation.

Preparing for Posterior Nasal Nerve Ablation

Before undergoing posterior nasal nerve ablation, you will have a pre-procedure consultation with your ENT specialist. During this consultation, the doctor will review your medical history, perform a physical examination, and discuss the procedure in detail.

To help assess your condition and plan for the procedure, you may undergo certain tests and assessments, such as:

  • Nasal endoscopy: This involves using a small, flexible scope to examine the nasal passages and identify any underlying issues.
  • Review of medical history: Your doctor will review your medical history, including any allergies, medications, or previous treatments for chronic rhinitis.

To prepare for the procedure, your doctor may provide specific instructions, which may include:

  • Adjusting medications: You may need to adjust certain medications, such as blood thinners, before the procedure.
  • Avoiding certain activities: It is important to avoid smoking and drinking alcohol for a certain period before the procedure.

By following these guidelines, you can help ensure a successful and safe procedure.

What Happens During the Procedure

Posterior nasal nerve ablation is typically performed on an outpatient basis, meaning you can go home on the same day. The procedure is usually quick, taking about 30-60 minutes to complete.

Here’s a general overview of the procedure:

  1. Local Anesthesia: Before the procedure begins, your doctor will administer local anesthesia to numb the nasal passages. This will help minimize any discomfort during the ablation process.
  2. Nerve Ablation: Using specialized probes or devices, your doctor will carefully target and ablate the specific nerves responsible for your chronic rhinitis symptoms. The method of ablation may vary, but it typically involves either radiofrequency energy or cryotherapy.
  3. Procedure Duration and Discomfort: The procedure is relatively quick and minimally invasive. You may experience some mild discomfort during the procedure, but this is usually well-tolerated due to the local anesthesia.

After the procedure, you may experience some mild discomfort or soreness in your nasal passages, which should subside within a few days.

Posterior Nasal Nerve Ablation Aftercare

Immediately after the procedure, you may experience some common sensations, including:

  • Numbness: The treated area may feel numb for a short period.
  • Mild discomfort: You may have mild discomfort or soreness in your nasal passages.
  • Nasal congestion: Some temporary nasal congestion is common.

To ensure a smooth recovery, it’s important to follow these post-procedure care instructions:

  • Avoid strenuous activities: Refrain from strenuous physical activity for a few days after the procedure.
  • Managing minor bleeding or nasal discharge: If you experience minor bleeding or nasal discharge, gently blot the area with a tissue. Avoid blowing your nose forcefully.
  • Potential side effects and normal recovery signs: While rare, some potential side effects may include mild bleeding, temporary changes in taste or smell, or a temporary burning sensation in the nasal passages. These side effects usually subside within a few days.

Recovery and Symptom Improvement

The timeline for symptom improvement can vary from person to person. However, many patients begin to notice a reduction in their symptoms within a few days to weeks after the procedure. The full benefits of the procedure may take several weeks or even months to fully realize.

To help manage your symptoms during recovery and optimize the long-term benefits of the procedure, consider the following tips:

  • Use of saline sprays or other prescribed post-care aids: Saline nasal sprays can help moisturize the nasal passages and alleviate dryness. Your doctor may also prescribe other medications or therapies to support your recovery.
  • Avoiding nasal irritants and certain activities: Avoid irritants such as smoke, dust, and strong odors, as these can exacerbate your symptoms. Refrain from activities that can dry out your nasal passages, such as excessive air conditioning or heating.

Risks and Potential Complications

While posterior nasal nerve ablation is generally a safe procedure, there are potential risks and complications to be aware of. These may include:

  • Bleeding: Minor bleeding from the nasal passages can occur after the procedure.
  • Infection: There is a small risk of infection at the treatment site.
  • Changes in sensation: Some patients experience temporary changes in sensation, such as numbness or altered taste or smell.

If you experience excessive bleeding, severe pain, or signs of infection, such as fever or increased drainage, it’s necessary to seek medical attention promptly.

The success rate of posterior nasal nerve ablation can vary depending on individual factors. However, it is generally considered to be a safe and effective treatment option for many people with chronic rhinitis. Compared to other treatments, such as medications or allergy immunotherapy, posterior nasal nerve ablation offers a targeted approach that can provide long-lasting relief for some individuals.

Many individuals experience significant improvement in their chronic rhinitis symptoms, leading to a better quality of life. In some cases, additional treatments are necessary for symptom relief. Regular follow-up appointments are necessary to assess the effectiveness of the procedure and monitor for any potential complications. During these appointments, your doctor will evaluate your symptoms and adjust your treatment plan if necessary.

Conclusion

Posterior nasal nerve ablation is a promising treatment for individuals with chronic rhinitis. By targeting specific nerves involved in the inflammatory process, this minimally invasive procedure can significantly reduce symptoms.

If you’re considering posterior nasal nerve ablation, contact us to schedule a consultation with Dr. Michael Bublik, Medical Director of Southern California ENT and Allergy Associates.