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    The content on this page is not current guidance and is only for the purposes of the consultation process.

    Existing assessments of this procedure

    The Triological Society reviewed the evidence to seek answering whether in-office PNN ablation is an effective treatment for the symptoms of AR (Davies 2022). Based on 4 single-arm prospective cohort studies (level 3) and 1 RCT (level 2), it was recommended that "although the number of randomised controlled trials (RCTs) is lacking, given the consistency of earlier prospective single-arm cohort studies, combined with the support of newer well-designed RCTs, there is enough evidence to support PNN as an effective treatment for allergic rhinitis symptoms, particularly nasal congestion, and rhinorrhoea. Given the favourable side effect profile of in-office PNN, there appears to be a role for cryoablation or radiofrequency neurolysis in treating symptoms of AR. Future studies should confirm these findings with additional RCTs using sham control procedures, longer follow-up, and larger and more diverse patient populations."

    The Japanese guidelines for allergic rhinitis 2020 (Okubo 2020) described an evidence-based step-by-step strategy for treatment. Operative treatment for AR was recommended as appropriate, such as cryosurgery and laser surgery.