ClariFix® vs Posterior Nasal Nerve Neurectomy: Which Treatment Is Best for Chronic Intrinsic Rhinitis?

Chronic intrinsic rhinitis—persistent nasal congestion, runny nose, and constant irritation—can have a huge impact on day-to-day life. When sprays and medications are no longer effective, patients often ask about procedures that target the posterior nasal nerve (PNN), the key nerve involved in driving these symptoms.

At Hampshire ENT Clinics, we offer modern treatments designed to reduce overactive nasal nerve function. Two of the most effective options are:

• ClariFix® cryotherapy, a quick freezing treatment

• Posterior nasal nerve (PNN) neurectomy, a more definitive endoscopic surgical procedure

Both target the same nerve pathway, but they differ significantly in technique, recovery, and long-term outcomes.

What Is ClariFix® Cryotherapy?

A minimally invasive, clinic-based procedure that uses targeted cold therapy to calm the overactive posterior nasal nerve.

How it works

A small probe delivers controlled cryotherapy (around –60°C) to the back of the nasal cavity. This reduces the nerve’s ability to send excessive “runny nose” and congestion signals.

Who it helps

ClariFix® is particularly effective for patients with:

• Vasomotor rhinitis

• Persistent symptoms despite sprays

• Post-viral nasal hypersensitivity

• Moderate chronic rhinitis not severe enough to merit surgery

• Patients wishing to avoid general anaesthesia

Benefits

• Performed under local anaesthetic

• Quick (around 30 minutes)

• Minimal downtime

• Very low risk

• No cutting, no surgical wounds

• Can be a little uncomfortable and result in some ‘brain-freeze’ type symptoms at the time of treatment

Limitations

• Results often take 4–6 weeks to become noticeable

• Effects can be variable

• May require repeat treatment

• Unsuitable for patients with significant structural nasal issues

What Is Posterior Nasal Nerve Neurectomy?

A precise endoscopic surgical procedure performed in theatre under general anaesthetic to more definitively divide the nerve branches that drive vasomotor rhinitis.

How it works

Using advanced endoscopic techniques, the surgeon identifies and interrupts the PNN branches at the level of the sphenopalatine area. This reduces the parasympathetic drive responsible for excessive nasal secretions and congestion.

Who it helps

PNN neurectomy is best suited for:

• Severe or refractory post-nasal drip

• Patients who have failed ClariFix® or medical therapy

• Individuals already undergoing septoplasty or sinus surgery

• Those seeking a long-term, more predictable solution

Benefits

• Stronger and more durable symptom improvement

• Can be combined with corrective nasal surgery

• Particularly effective for non-allergic and mixed rhinitis

Limitations

• Requires general anaesthetic

• Mild postoperative bleeding or crusting is possible

• Slightly longer recovery than ClariFix®

• Not suitable for all patients

Which Option Is Right for You?

If you’re struggling with chronic nasal symptoms, both treatments offer excellent outcomes when carefully matched to the right patient.

📞 To book an appointment at Hampshire ENT Clinics, we can create a tailored plan to improve your breathing, reduce runny nose symptoms, and regain control of your day-to-day comfort.

Frequently Asked Questions (FAQs)

What is chronic intrinsic (vasomotor) rhinitis?
Chronic intrinsic rhinitis is long-standing nasal congestion, runny nose, or irritation that is not caused by allergy or infection. Symptoms are driven by overactive nasal nerves rather than inflammation from allergens.

What is the posterior nasal nerve (PNN) and why is it important?
The posterior nasal nerve controls mucus production and congestion within the nose. In intrinsic rhinitis, this nerve becomes overactive, leading to persistent symptoms. Both ClariFix® and PNN neurectomy aim to reduce this nerve signalling.

Is ClariFix® painful?
ClariFix® is performed under local anaesthetic. Some patients experience brief discomfort or a “brain-freeze” sensation during treatment, but this settles quickly. Most patients tolerate the procedure well.

How long does ClariFix® take to work?
Improvement is gradual. Most patients notice benefit within 4–6 weeks, as the nerve response slowly reduces.

How long do the results of ClariFix® last?
Many patients experience sustained improvement, but results can vary. Some may require repeat treatment if symptoms return.

What is posterior nasal nerve neurectomy?
PNN neurectomy is an endoscopic surgical procedure performed under general anaesthetic to divide the nerve branches more definitively. It provides a stronger and more predictable reduction in symptoms.

Is PNN neurectomy permanent?
It is considered a long-term solution for appropriate patients. While no procedure can guarantee lifelong results, symptom improvement is generally more durable than with less invasive options.

Which treatment should I try first?
This depends on symptom severity, previous treatments, and nasal anatomy. ClariFix® is often used as a first procedural step, while PNN neurectomy is reserved for more severe or refractory cases or when combined with other nasal surgery.

Can these procedures improve post-nasal drip?
Yes. Both treatments can significantly reduce post-nasal drip when it is driven by intrinsic rhinitis and overactive nasal nerve signalling.

Do I need to have failed nasal sprays before considering these options?
Yes. These procedures are usually considered when medical therapy (including steroid sprays and saline rinses) has not provided adequate relief.

How do I know which option is right for me?
A detailed ENT assessment is essential. This includes a history, nasal examination (often with endoscopy), and discussion of your goals to determine the most appropriate and effective treatment.