Hostname: page-component-586b7cd67f-dlnhk Total loading time: 0 Render date: 2024-11-28T01:54:01.040Z Has data issue: false hasContentIssue false
  • English
  • Français

Is the effect of topical intranasal steroids on obstructive adenoids transient or long-lasting? Case series and systematic review of literature

Published online by Cambridge University Press:  05 February 2016

M A Bitar ,
J Nassar  and
R Dana
M A Bitar*
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Faculty of Medicine and Medical Center, American University of Beirut, Lebanon Department of Pediatrics and Adolescent Medicine, Faculty of Medicine and Medical Center, American University of Beirut, Lebanon Department of ENT Surgery, Children's Hospital at Westmead, Sydney, Australia Pediatric Otolaryngology Program, Al Jalila Children's Specialty Hospital, Dubai, United Arab Emirates
J Nassar
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Faculty of Medicine and Medical Center, American University of Beirut, Lebanon Department of Otolaryngology Head and Neck Surgery, King Abdulaziz Medical City – National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia
R Dana
Affiliation:
private clinic (paediatrics), Beirut, Lebanon
*
Address for correspondence: Dr Mohamad A Bitar, Pediatric Otolaryngology Program, Al Jalila Children's Specialty Hospital, PO Box 7662, Dubai, UAE E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives:

To study and review the short- and long-term effects of intranasal steroids on obstructive adenoids.

Methods:

In this prospective cohort study, 19 children previously treated with mometasone furoate for 3 months were contacted at 3, 6 and 12 months after cessation of treatment. Main outcome measures included: change in severity of nasal obstruction, allergic rhinitis and obstructive symptoms. A systematic review of literature was also performed.

Results:

By one year, 25 per cent of patients required adenoidectomy; the remaining children had no significant change in clinical score (p = 0.464), obstruction severity (p = 0.191) or allergic symptoms (p = 0.284). Fourteen pertinent studies were identified; all but one study showed improvement in the patients’ symptoms and/or degree of obstruction. Two studies with follow up reaching 25 months showed positive effects.

Conclusion:

The short-term positive effect of some intranasal steroids on obstructive adenoids seems to persist in a significant number of patients after the cessation of treatment.

Keywords

AdenoidNasal ObstructionIntranasal Drug AdministrationSteroidsFollow-Up StudiesMometasone Furoate
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 130 , Issue 4 , April 2016 , pp. 357 - 362
Copyright
Copyright © JLO (1984) Limited 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Presented at the Australian Society of Otolaryngology Head and Neck Surgery Annual Scientific Meeting, 29 March – 1 April 2014, Brisbane, Australia.

References

1Demain, JG, Goetz, DW. Pediatric adenoidal hypertrophy and nasal airway obstruction: reduction with aqueous nasal beclomethasone. Pediatrics 1995;95:355–64CrossRefGoogle ScholarPubMed
2Chadha, NK, Zhang, L, Mendoza-Sassi, RA, César, JA. Using nasal steroids to treat nasal obstruction caused by adenoid hypertrophy: does it work? Otolaryngol Head Neck Surg 2009;140:139–47Google Scholar
3Berlucchi, M, Salsi, D, Valetti, L, Parrinello, G, Nicolai, P. The role of mometasone furoate aqueous nasal spray in the treatment of adenoidal hypertrophy in the pediatric age group: preliminary results of a prospective, randomized study. Pediatrics 2007;119:e1392–7Google Scholar
4Cengel, S, 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;70:639–45CrossRefGoogle ScholarPubMed
5Bitar, MA, Mahfoud, L, Nassar, J, Dana, R. Exploring the characteristics of children with obstructive adenoid responding to mometasone furoate monohydrate: preliminary results. Eur Arch Otorhinolaryngol 2013;270:931–7Google Scholar
6Berlucchi, M, Valetti, L, Parrinello, G, Nicolai, P. Long-term follow-up of children undergoing topical intranasal steroid therapy for adenoidal hypertrophy. Int J Pediatr Otorhinolaryngol 2008;72:1171–5CrossRefGoogle ScholarPubMed
7Bachert, C, van Cauwenberge, P, Khaltaev, N; World Health Organization. Allergic Rhinitis and its Impact on Asthma (ARIA). In collaboration with the World Health Organization. Executive summary of the workshop report. 7-10 December 1999, Geneva, Switzerland. Allergy 2002;57:841–55Google Scholar
8Bitar, MA, Rahi, A, Khalife, M, Madanat, LM. A suggested clinical score to predict the severity of adenoid obstruction in children. Eur Arch Otorhinolaryngol 2006;263:924–8CrossRefGoogle ScholarPubMed
9Brouillette, RT, Manoukian, JJ, Ducharme, FM, Oudjhane, K, Earle, LG, Ladan, S et al. Efficacy of fluticasone nasal spray for pediatric obstructive sleep apnea. J Pediatr 2001;138:838–44CrossRefGoogle ScholarPubMed
10Lepcha, A, Kurien, M, Job, A, Jeyaseelan L, Thomas K. Chronic adenoid hypertrophy in children – is steroid nasal spray beneficial? Indian J Otolaryngol Head Neck Surg 2002;54:280–4Google Scholar
11Criscuoli, G, D'Amora, S, Ripa, G, Cinquegrana, G, Mansi, N, Impagliazzo, N et al. Frequency of surgery among children who have adenotonsillar hypertrophy and improve after treatment with nasal beclomethasone. Pediatrics 2003;111:e236–8CrossRefGoogle ScholarPubMed
12Ciprandi, G, Varricchio, A, Capasso, M, Varricchio, AM, De Lucia, A, Ascione, E et al. Intranasal flunisolide treatment in children with adenoidal hypertrophy. Int J Immunopathol Pharmacol 2007;20:833–6Google Scholar
13Kheirandish-Gozal, L, Gozal, D. Intranasal budesonide treatment for children with mild obstructive sleep apnea syndrome. Pediatrics 2008;122:e149–55Google Scholar
14Varricchio, A, Tortoriello, G, Capasso, M, De Lucia, A, Marchisio, P, Varricchio, AM et al. Prevention of surgery in children with adenoidal hypertrophy treated with intranasal flunisolide: a 12-month follow-up. J Biol Regul Homeost Agents 2009;23:95–101Google ScholarPubMed
15Demirhan, H, Aksoy, F, Ozturan, O, Yildirim, YS, Veyseller, B. Medical treatment of adenoid hypertrophy with “fluticasone propionate nasal drops”. Int J Pediatr Otorhinolaryngol 2010;74:773–6CrossRefGoogle ScholarPubMed
16Jung, YG, 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;4:27–32CrossRefGoogle ScholarPubMed
17Rezende, RM, Silveira, F, Barbosa, AP, Menezes, UP, Ferriani, VP, Rezende, PH et al. Objective reduction in adenoid tissue after mometasone furoate treatment. Int J Pediatr Otorhinolaryngol 2012;76:829–31Google Scholar