{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T15:41:23Z","timestamp":1791301283236,"version":"4.1.0"},"reference-count":18,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,3,25]],"date-time":"2024-03-25T00:00:00Z","timestamp":1711324800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Laryngoscope Investig Oto"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Posterior nasal nerve (PNN) ablation is a minimally invasive treatment option for patients with chronic rhinitis. Recent evidence shows that parasympathetic innervation of the nasal cavity is more extensive and there are many fibers posterior to the lateral attachment of the middle turbinate. We describe a modified ablative technique that targets the extensive innervation of the posterior nasal nerves.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Description of the technique and retrospective cohort analysis. In addition to the traditional radiofrequency and cryoablation targets, three additional treatment sites posterior to the middle turbinate were targeted using radiofrequency ablation, as well as one focused treatment posteroinferior to the middle turbinate attachment using cryotherapy ablation. The primary outcome collected was a 30% improvement in overall rhinitis symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty\u2010five patients received treatment and completed 3\u2010month follow\u2010up using the modified technique for radiofrequency and cryotherapy PNN ablation. Previously, our institution documented a 64.5% responder rate at 3\u2009months. After introducing the modified technique, the response rate at 3\u2009months significantly improved (64.5% vs. 91.1%, <jats:italic>p<\/jats:italic>\u2009=\u2009.004).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This report suggests improved efficacy with implementation of the modified technique for in\u2010office PNN ablation. Given the extensive nature of the post\u2010ganglionic parasympathetic fibers of the nasal cavity which often emerge posterior to the middle turbinate attachment, a modified technique to target these branches should be considered. Prospective randomized studies comparing this modified technique to the traditional technique are needed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>III.<\/jats:p><\/jats:sec>","DOI":"10.1002\/lio2.1238","type":"journal-article","created":{"date-parts":[[2024,3,25]],"date-time":"2024-03-25T11:34:05Z","timestamp":1711366445000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Modified technique improves efficacy for in\u2010office posterior nasal nerve ablation"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7998-6949","authenticated-orcid":false,"given":"Daniel","family":"Gorelik","sequence":"first","affiliation":[{"name":"Division of Rhinology and Skull Base Surgery, Department of Otolaryngology\u2010Head and Neck Surgery Houston Methodist Hospital  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8926-7662","authenticated-orcid":false,"given":"Aatin K.","family":"Dhanda","sequence":"additional","affiliation":[{"name":"Rutgers New Jersey Medical School  Newark New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masayoshi","family":"Takashima","sequence":"additional","affiliation":[{"name":"Division of Rhinology and Skull Base Surgery, Department of Otolaryngology\u2010Head and Neck Surgery Houston Methodist Hospital  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Najm S.","family":"Khan","sequence":"additional","affiliation":[{"name":"Division of Rhinology and Skull Base Surgery, Department of Otolaryngology\u2010Head and Neck Surgery Houston Methodist Hospital  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1296-2648","authenticated-orcid":false,"given":"Nicholas R.","family":"Rowan","sequence":"additional","affiliation":[{"name":"Division of Rhinology and Skull Base Surgery, Department of Otolaryngology \u2013 Head and Neck Surgery Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5254-3221","authenticated-orcid":false,"given":"Aria","family":"Jafari","sequence":"additional","affiliation":[{"name":"Division of Rhinology and Endoscopic Skull Base Surgery, Department of Otolaryngology\u2013Head and Neck Surgery University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tariq","family":"Syed","sequence":"additional","affiliation":[{"name":"Division of Rhinology and Skull Base Surgery, Department of Otolaryngology\u2010Head and Neck Surgery Houston Methodist Hospital  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar G.","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Division of Rhinology and Skull Base Surgery, Department of Otolaryngology\u2010Head and Neck Surgery Houston Methodist Hospital  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,3,25]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"23","article-title":"Epidemiology of rhinitis: allergic and nonallergic","volume":"19","author":"Settipane RA","year":"2007","journal-title":"Clin Allergy 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