DOES INTRANASAL STEROIDS REDUCE THE NEED OF ADENOIDECTOMY IN ADENOID HYPERTROPHY

Abstract

Sudeep Madisetti1, Vineel Muppidi2, Lingaiah Jadi3, Kalicheti Prabhakar Reddy4, Divya Batchu5

BACKGROUND
Adenoidal hypertrophy is one of the common pathological condition in the paediatric population. Adenoid hypertrophy manifests as bilateral nasal obstruction, rhinorrhea, cough, snoring, hyponasal speech and sleep apnoea. At present, complications and sequelae of adenoidectomy (i.e., alteration of the immunological system, postoperative bleeding and recurrence of adenoids) are object of criticism. For this reason, research was conducted to test the efficacy of topical nasal steroids in decreasing the severity of nasal symptoms and adenoidal mass.
MATERIALS AND METHODS
This prospective, controlled study includes 60 children between the ages of 3-12 yrs. who presented with symptoms of adenoid hypertrophy. The study group (33 subjects) underwent course of antibiotic therapy (amoxicillin and potassium clavulanate/cefpodoxime proxetil/cefuroxime axetil) along with mometasone furoate nasal spray 50 mcg in each nostril (100 mcg/day) once daily for 6 weeks, whereas the control group (27 subjects) treated symptomatically with course of antibiotic therapy and saline nasal drops. We assessed the effectiveness of intranasal corticosteroids for improving nasal airway obstruction, thus reducing the need for adenoidectomy.
RESULTS
We tested the efficacy of Mometasone Furoate (MF) monohydrate to improve the symptom scores of patients with adenoid hypertrophy. 60 children (3-12 years old) were enrolled in a prospective, controlled, clinical study. At the end of the trial, symptom scores improved significantly in the steroid group, while no significant improvements were observed in control patients.
CONCLUSION
Usage of nasal steroid spray is safe and well tolerated in children. Intranasal steroid therapy can be considered as a treatment option in children with adenoid hypertrophy and in patients who are not willing to undergo or are contraindicated for surgery. In case of failure of intranasal steroidal therapy, adenoidectomy remains the procedure of choice.

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