What Is NEUROMARK® — And Could It Stop Your Chronic Runny Nose for Good?

The short answer: NEUROMARK® is a radiofrequency tool that treats the posterior nasal nerves — the overactive signaling pathway responsible for chronic runny nose, post-nasal drip, and excess drainage. It is performed in-office under local anesthesia, takes minutes per side, and 80% of patients notice significant improvement by six weeks. It is the only procedure of its kind that treats the nerve without excising any tissue.

By Franklyn R. Gergits, DO, MBA, FAOCO · Sinus & Allergy Wellness Center of North Scottsdale · Airway & Sinus Wellness Review

Chronic runny nose is one of the most frustrating conditions I see in clinical practice. Patients have tried every antihistamine, every nasal spray, every allergy protocol. The drainage keeps coming. The dripping never stops. The throat is always wet. They sleep poorly, they cough constantly, and they have been told — incorrectly — that nothing can be done.

NEUROMARK® changes that. Here is everything you need to know.

What NEUROMARK® Actually Is

NEUROMARK® is a radiofrequency delivery tool used to treat the posterior nasal nerves located at the posterior lateral attachment of the middle turbinate to the lateral nasal cavity. The device uses metal wire paddles to deliver radiofrequency energy with significantly greater surface area coverage than earlier-generation devices like RhinAer® or ClariFix®. That increased surface area means more complete nerve treatment and better clinical outcomes.

It is manufactured by Neurent Medical and is FDA-cleared.

Why the Posterior Nasal Nerves Are the Target

As the inflammation burden in the nose and sinuses increases — from chronic sinusitis, reflux, allergy, or posterior mucosal injury — it triggers the posterior nasal nerves to become overactive. Overactive posterior nasal nerves drive excess production of post-nasal drainage. That drainage is not just an annoyance. It produces post-nasal drip, chronic cough, hoarseness, globus sensation, Eustachian tube dysfunction, and in some patients it contributes to asthma flares and migraine-pattern headaches.

Antihistamines and nasal sprays treat the symptoms — the drainage itself — but they do not treat the nerve overactivity driving the production. That is why the drainage returns the moment you stop the medication. NEUROMARK® treats the source, not the symptom.

Who Is the Ideal Candidate

The ideal NEUROMARK® candidate has excess post-nasal drainage as a primary complaint. They may have been unsuccessfully treated with ClariFix® or RhinAer® — the prior generation of posterior nasal nerve treatments — and are still symptomatic. They often present with a cluster of related symptoms: chronic post-nasal drip, morning cough, hoarseness, globus sensation, Eustachian tube dysfunction, or recurrent sinus infections.

An important point that many patients do not know: NEUROMARK® can also be used to reduce posterior mulberry turbinate enlargement and hypertrophy. This is a distinct application — treating turbinate tissue rather than the nerve alone — that further broadens who benefits from the procedure.

What Happens During the Procedure

The anesthesia protocol is the same we use for balloon sinuplasty, Eustachian tube dilation, and turbinate reduction: topical lidocaine with epinephrine, tetracaine with epinephrine gel applied directly to the nasal mucosa, followed by a local injection of 1% lidocaine with epinephrine. This combination provides complete anesthesia for the procedure.

Once anesthesia is established, the NEUROMARK® probe is advanced to the posterior nasopharynx. The patient feels pressure as the probe is positioned — not pain. The wire paddles are deployed and positioned at the posterior nasal nerve. Radiofrequency energy is then delivered for approximately 30 seconds per treatment site. There are six possible delivery options on each side, allowing the treatment to be customized to each patient’s anatomy. The procedure is then repeated on the opposite side.

Most patients are surprised by how quickly it is over and how manageable the experience is.

What Results to Expect

Neural modulation takes time. The radiofrequency energy begins remodeling the nerve immediately, but the clinical effect develops over weeks as the afferent and efferent signaling channels are optimized. Eighty percent of patients notice meaningful improvement by six weeks. The improvement is not subtle — patients describe it as a dramatic reduction in drainage, a drier posterior nasal space, better sleep, and relief from the chronic cough that has been present for years.

At two years, 75% of patients still have significant benefit. That durability is the most important number I share with patients. When a treatment holds at two years, it suggests we are treating the root cause — not masking a symptom that will return the moment the treatment stops.

The Empty Nose Syndrome Question

Empty nose syndrome is real. For some patients it goes unnoticed. For others it is a devastating, debilitating condition that permanently alters quality of life. It results from excessive removal of turbinate tissue — missing neural signaling to the brain that normal airflow is occurring through the nasal passages.

NEUROMARK® carries no risk of empty nose syndrome. It is a transmucosal delivery system — the radiofrequency energy is delivered through the intact mucosa without any excision of turbinate tissue. No tissue is removed. No mucosal surface is destroyed. The nerve is modulated, not ablated. Neural signaling remains intact.

This is the fundamental distinction between NEUROMARK® and procedures that involve tissue removal. I make it explicitly clear to every patient who raises this concern, because it is the right concern to raise.

Why I Perform NEUROMARK® as Part of the Combination Procedure

The procedures I perform — balloon sinuplasty, turbinate reduction, nasal septal swell body reduction, Eustachian tube dilation, and NEUROMARK® — each improve validated patient outcomes independently. SNOT scores improve with balloon sinuplasty. EDQ-7 scores improve with Eustachian tube dilation. NOSE scores improve with turbinate and swell body reduction. NEUROMARK® improves all of these metrics as well.

When you combine them at the same visit, the benefit compounds. One anesthesia event. One recovery. One set of discharge instructions. And a patient who walks out with every component of their nasal and sinus dysfunction addressed simultaneously rather than sequentially over years.

We intend to study these combined outcomes formally. The data will come from our own patients, with our own metrics, built on the clinical philosophy that has guided this practice for over 30 years.

Want to Understand More?

This post is part of the Understanding Your Symptoms series on the Airway & Sinus Wellness Review.

→ What Is Balloon Sinuplasty — And Are You a Candidate?

→ What Actually Happens During Your Procedure — Every Step, Start to Finish

→ What to Expect After Your In-Office Sinus Procedure

→ Airway & Sinus Wellness Review — Full Publication

About the Author

Franklyn R. Gergits, DO, MBA, FAOCO is an otolaryngologist and rhinologist with over 30 years of clinical experience. He is the founder of the Sinus & Allergy Wellness Center of North Scottsdale, where he performs in-office balloon sinuplasty, turbinate reduction, NEUROMARK® posterior nasal nerve ablation (Neurent Medical, FDA-cleared radiofrequency ablation — no financial relationship with Neurent), and Eustachian tube dilation under local anesthesia. He performed the first balloon sinuplasty in Pennsylvania and holds dual Entellus Centers of Excellence certifications. Dr. Gergits is the originator of the Posterior Sinonasal Syndrome (PSS) hypothesis, with a preprint available at Preprints.org (DOI: 10.20944/preprints202603.0858.v1). ORCID: 0009-0000-4893-6332.

SinusAndAllergyWellnessCenter.com · 480-525-8999 · Airway & Sinus Wellness Review

This content is for educational purposes only and does not constitute medical advice. Individual results vary. Consult a qualified physician for evaluation and individualized recommendations.