DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20204186

Role of mometasone furoate nasal spray versus saline nasal spray in treatment of adenoid hypertrophy: a prospective, randomized study

Rabia Monga, Sanjeev Bhagat, Vishal Sharma, Dimple Sahni, Harjinder Singh, Dinesh Kumar Sharma

Abstract


Background: Adenoid hypertrophy is a common disorder in the paediatric population, presenting with multiple signs and symptoms ranging from nasal obstruction to obstructive sleep apnoea. Most common symptom is usually nasal airway obstruction. This prospective, randomized study aims to evaluate the efficacy of mometasone furoate spray in reducing size and clinical symptoms in patients with adenoid hypertrophy compared to saline spray.

Methods: 60 patients in the age group of 3-11 years were enrolled in the study. Five symptoms were included that were hypo nasal speech, snoring, night cough, open mouth breathing and nasal obstruction which were scored as never=0, mild (sometimes)=1, moderate (less than 50% of times)=2, and severe (constant)=3. Diagnosis of adenoid hypertrophy was made on basis of nasal endoscopy.

Results: Significant improvement was seen in individual as well as overall symptom score in group A as compared to group B after 8 weeks of treatment (p<0.001). There was significant improvement in mean adenoid grade as per nasal endoscopy at 8 weeks post therapy (p<0.001) which was not seen after 4 weeks of therapy.

Conclusion: Intranasal steroid sprays have good role in decreasing the symptoms of adenoid hypertrophy and has reduced number of adenoidectomies required. The long-term effects as well as optimal duration of therapy is still controversial and needs to be studied further.


Keywords


Adenoid hypertrophy, Mometasone nasal spray, Adenoidectomy, Nasal obstruction

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References


Berlucchi M, Salsi D, Valetti L, Parrinello G, Nicolai P. The role of mometasone furoate aqueous nasal spray in the treatment of Adenoid Hypertrophy in the pediatric age: preliminary results of a prospective randomized study. Pediatrics. 2007;119(6):1392-97.

Ciprandi G, Varricchio A and Capasso M. Intranasal flunisolide treatment in children with adenoidal hypertrophy. International Journal of Immunopathology and Pharmacology. 2007;20(4):833-36.

Zhang L, Mendoza-Sassi RA, César JA, Chadha NK. Intranasal corticosteroids for nasal airway obstruction in children with moderate to severe adenoidal hypertrophy. Cochrane Database of Systematic Reviews. 2008;3:CD006286.

Paulussen C, Claes J, Claes G, Jorissen M. Adenoids and tonsils, indications for surgery and immunological consequences of surgery. Acta Otorhinolaryngol Belg. 2000;54:403-8.

Jung YG, MD, Kim HY, Min JY, Dhong HJ, Chung SK. Role of Intranasal Topical Steroid in Pediatric Sleep Disordered Breathing and Influence of Allergy, Sinusitis, and Obesity on Treatment Outcome. Clin Exp Otorhinolaryngol. 2011;4(1):27-32.

Robb PJ. Scott-Brown’s Otorhinolaryngology, Head and Neck Surgery.7th Edition. London: Hodder Arnold. 2008.

Chinawa JM, Akpeh JO, Chinawa AT. Clinical profile and pattern of adenoid hypertrophy among children attending a private hospital in Enugu, South East Nigeria. Pan African Medical Journal. 2015;21:191.

Eziyi JA, Amusa YB, Nwawolo C. The prevalence of nasal diseases in Nigerian school children. Journal of Medicine and Medical Sci. 2014;5(4):71-7.

Cassano M, Gelardi M, Cassano ML, Fiorella R. Adenoid tissue rhinopharyngeal obstruction grading based on fiberendoscopic findings: a novel approach to therapeutic management, Int. J. Pediatr. Otorhinolaryngol. 2003;67:1303-9.

Demirhan H, Aksoy F, zturan O, Yıldırım Y S, Veyseller B. Medical treatment of adenoid hypertrophy with ‘‘fluticasone propionate nasal Drops. International Journal of Pediatric Otorhinolaryngology. 2010;74:773-6.

Cengel S and Akyol MU. The role of topical nasal steroids in the treatment of children with otitis media with effusion and/or Adenoid Hypertrophy. Int J Pediatr Otorhinolaryngol. 2006;70(4):639-45.

Yilmaz HB, Celebi S, Yilmaz AS, Oysu C. The role of mometasone furoate nasal spray in the treatment of adenoidal hypertrophy in the adolescents: a prospective, randomized, cross-over study. European Archives of Oto-Rhino-Laryngology. 2013;270(10):2657-61.

Usta BE, Arslan Z, zmen O, Atmaca S, Aslan B. The Effect of Nasal Mometasone Furoate in Children with Hypertrophy of Adenoids. Asthma Allergy Immunology. 2003;1:17-24.