糠酸莫米松鼻喷剂和孟鲁司特钠联合治疗儿童腺样体肥大的疗效观察

目的：探讨儿童腺样体肥大的非手术治疗方法及其疗效。方法联合使用糠酸莫米松鼻喷剂和孟鲁司特钠治疗儿童腺样体肥大30例,按照腺样体大小分为轻度12例、中度11例、重度7例三组,同时按照有无变应性鼻炎分为伴变应性鼻炎组19例和不伴变应性鼻炎组11例。患者的症状评分根据Carlos O’Connor-Reina的家长调查问卷获得。结果轻度组中有效率91.7%（11/12）,中度组有效率63.6%（7/11）,重度组有效率14.3%（1/7）。伴变应性鼻炎组有效率73.7%（14/19）,不伴变应性鼻炎组有效率36.4%（4/11）。结论糠酸莫米松鼻喷剂联合孟鲁司特钠是非手术治疗腺样体肥大一个较好的方法,但各组效果不一。轻度腺样体肥大效果较好,重度腺样体肥大效果较差。对于伴有变应性鼻炎的腺样体肥大治疗效果明显优于不伴有变应性鼻炎的。     

玉屏风颗粒联合鼻用激素治疗儿童中重度腺样体肥大的临床观察

目的总结玉屏风颗粒联合鼻用激素治疗儿童中重度腺样体肥大的临床体会。方法拒绝接受手术治疗的腺样体肥大患儿30例,依据鼻咽侧位片A/N比值评判腺样体大小,包括中度肥大17例,重度肥大13例,予以玉屏风颗粒口服,鼻用激素丙酸氟替卡松或曲安奈德鼻喷剂喷鼻,连续治疗3月。观察比较治疗前后患儿相关症状变化及腺样体体积改变,评价治疗效果,并结合文献复习探讨其病机特点,分析临床疗效。结果经连续3月以上治疗,中度腺样体肥大患儿显效11例(11/17,64.71%),有效3例(3/17,17.64%),总有效率(14/17,82.35%);重度腺样体肥大患儿显效6例(6/13,46.15%),有效4例(4/13,30.76%),总有效率(10/13,76.92%)。经半年以上随访,多数患儿基本维持有效现状,但有5例因病情反复而接受手术治疗(5/24,20.83%)。结论对于中度以及拒绝手术治疗的重度腺样体肥大患儿,可以考虑采用玉屏风颗粒联合鼻用激素疗法治疗观察3~6月,仍无症状改善者,则宜积极考虑手术疗法。     

鼻内镜手术联合鼻用糖皮质激素治疗腺样体肥大性

目的 探讨鼻用糖皮质激素辅助鼻内镜下腺样体切除术治疗腺样体肥大性小儿鼾症的临床效果及安全性。 方法 选取腺样体肥大性小儿鼾症患者98例为研究对象,采用随机平行对照法将其分为2个组各49例。对照组给予鼻内镜下腺样体切除术,以及口服头孢克洛颗粒、雾化吸入地塞米松等常规治疗。观察组在对照组基础上给予鼻用糖皮质激素喷鼻。比较两组治疗有效率、不良反应发生率、治疗前后鼻咽侧位片A/N值、呼吸暂停低通气指数、睡眠质量、免疫与炎症因子水平的差异。 结果 观察组总有效率为89.80%(44/49),对照组为73.47%(36/49),观察组显著高于对照组(χ2=4.356, P=0.037)。观察组出现鼻出血1例,鼻前庭干燥感1例,发生率为4.08%,对照组未见鼻出血及鼻前庭干燥感发生,两组不良反应发生率比较差异无统计学意义(P>0.05)。治疗前,两组鼻咽侧位片A/N值、呼吸暂停低通气指数及睡眠质量比较差异无统计学意义(P>0.05),治疗后两组鼻咽侧位片A/N值、呼吸暂停低通气指数及睡眠质量均改善,且组间比较差异有统计学意义(P<0.05)。治疗前,两组IgE、LTE4、TNF-α、IL-6、IL-8比较差异无统计学意义(P>0.05),治疗后,两组IgE、LTE4、TNF-α、IL-6、IL-8均降低,且组间比较差异有统计学意义(P<0.05)。 结论 对腺样体肥大性小儿鼾症患者,给予鼻用糖皮质激素辅助鼻内镜腺样体切除术治疗能够通过抑制炎症因子释放,改善打鼾、鼻塞等临床症状,且风险较小,患儿睡眠质量较高,值得推广应用。     

腺样体大小及圆枕类型对儿童分泌性中耳炎的影响

目的 探讨腺样体大小及圆枕类型对儿童分泌性中耳炎的影响。 方法 选择120例分泌性中耳炎患儿为病例组,同期体检的正常儿童120例为对照组,对2个组儿童进行听力及电子鼻咽镜检查,比较两组腺样体大小、圆枕类型的差异及与听力损失程度的相关性。 结果 病例组Ⅲ~Ⅳ度腺样体及Ⅱ~Ⅲ型圆枕的比例均为77.5%,明显高于对照组的37.5%、46.7%,发病风险明显高于本组Ⅰ~Ⅱ度腺样体及Ⅰ型圆枕,差异有统计学意义(P<0.05)。对两组的腺样体大小、圆枕类型行趋势χ2检验,差异有统计学意义(P<0.05)。但病例组腺样体大小及圆枕类型与听力损失程度无相关性(r值分别为0.135、0.049,P值均>0.05)。 结论 腺样体肥大及Ⅱ~Ⅲ型圆枕是儿童分泌性中耳炎的危险因素。腺样体及圆枕类型的常规检查和评估,有助于儿童分泌性中耳炎的尽早诊治。     

儿童阻塞性睡眠呼吸暂停低通气综合征危险因素的

目的 研究儿童阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的潜在危险因素及其因素之间的协同作用。 方法 因打鼾、呼吸音粗、张口呼吸等就诊福建省福州儿童医院耳鼻咽喉科行多导睡眠(PSG)监测的患儿纳入研究对象。经过PSG监测确诊为OSAHS的321例临床病例资料完整的患儿为病例组(OSAHS组)。采用年龄和性别匹配的方法,纳入经过PSG监测排除OSAHS的321例临床资料完整的儿童作为对照组。收集这两组患儿口咽部检查和电子鼻咽喉镜等检查结果的临床病例资料进行回顾性分析。 结果 多因素回归分析显示,伴有鼻窦炎的患儿OSAHS发生率较无鼻窦炎时高3.229 78倍(P<0.001);与Ⅰ度扁桃体比较,Ⅱ度扁桃体发生儿童OSAHS的OR为1.596 58(P=0.032 2),Ⅲ度和Ⅳ度扁桃体发生儿童OSAHS的OR分别为2.306 52(P=0.000 8)和4.430 85(P<0.001)。与Ⅰ度腺样体比较,Ⅱ度腺样体发生儿童OSAHS的OR为1.804 33(P=0.005 1),Ⅲ度和Ⅳ度腺样体发生儿童OSAHS的OR分别为2.883 38(P<0.001)和3.220 91(P=0.000 2)。分层分析显示,伴有鼻窦炎的患者中随着腺样体肥大程度的递增,OSAHS的发病危险增加的趋势高于不伴有鼻窦炎的患者(P=0.004 1)。 结论 儿童阻塞性睡眠呼吸暂停低通气综合征是多因素共同作用的结果,其中腺样体肥大、扁桃体肥大、鼻窦炎是儿童OSAHS的独立危险因素。鼻窦炎可以与肥大的腺样体产生协同作用,共同增加OSAHS的发病风险。     

布地奈德体位滴鼻治疗伴腺样体肥大的小儿分泌性中耳炎31例

目的 探讨布地奈德体位滴鼻治疗伴有腺样体肥大的小儿分泌性中耳炎的疗效。 方法 选取伴腺样体肥大的分泌性中耳炎患儿62例作为研究对象,按治疗方法不同分为治疗组和对照组,每组各31例,治疗组予布地奈德体位滴鼻,对照组行等待观察,对两组临床效果进行分析比较。 结果 治疗组有效率为83.87%,对照组有效率为61.29%,差异有统计学意义(P<0.05)。 结论 布地奈德体位滴鼻在治疗伴有腺样体肥大的小儿分泌性中耳炎中疗效显著,局部应用不良反应小。     

鼻内镜下等离子射频消融术对合并鼻窦炎的小儿腺样体肥大患者疗效及鼻腔黏膜纤毛清除功能的影响

目的 探讨鼻内镜下等离子射频消融术治疗小儿腺样体肥大并鼻窦炎的临床疗效及对鼻腔黏膜纤毛清除功能的影响。 方法 选取腺样体肥大并鼻窦炎患儿96例,随机平均分为两组,对照组采用普通手术切除法,观察组采用低温等离子射频消融法,对比两组患者的手术时间、术中出血量、鼻内镜下评分下降幅值,采用糖精试验测定手术前后鼻腔黏膜纤毛传输速率(MTR)。 结果 两组患者的临床疗效比较差异无统计学意义(P>0.05)。两组患者的手术时间、术中出血量及鼻内镜下评分下降幅值比较,差异有统计学意义(P<0.05)。与手术前比较,对照组患者手术后MTR差异无统计学意义(P>0.05),观察组患者手术后MTR差异有统计学意义(P<0.05);与治疗组比较,观察组患者手术后MTR差异有统计学意义(P<0.05)。 结论 鼻内镜下等离子射频消融术治疗小儿腺体肥大并鼻窦炎的术中出血量少、手术时间短且对患者鼻腔黏膜纤毛清除功能影响不明显,临床疗效显著。     

OSA-18量表评估腺样体肥大儿童生活质量

目的 采用儿童阻塞性睡眠呼吸暂停低通气综合征(OSAHS)疾病特异性生活质量调查(OSA-18)量表, 评估腺样体肥大患儿生活质量, 以期了解OSA-18量表是否可作为临床评估腺样体肥大患儿生活质量状况的指标。方法 对符合入选标准的腺样体肥大患儿56例, 行电子鼻咽镜及多导睡眠监测(PSG)检查, 并采用OSA-18量表对其进行生活质量评估, 分析腺样体肥大病情程度与OSA-18评分的相关性。结果 80.36%的腺样体肥大患儿生活质量受到明显影响, OSA-18总体评分为"中度+重度"。OSA-18总体评分与呼吸暂停低通气指数(AHI)、最低血氧饱和度(LSaO₂)及腺样体大小存在明显的相关关系。结论 腺样体肥大程度与OSA-18评分之间存在相关性, OSA-18量表评分可作为临床评估腺样体肥大患儿生活质量状况的指标。     

补肺健脾散结法治疗肺脾气虚型儿童腺样体肥大的临床研究

目的观察补肺健脾散结法治疗肺脾气虚型儿童腺样体肥大的临床疗效。方法将肺脾气虚型腺样体肥大的患者72例随机分为治疗组(38人),对照组(34人),治疗组以补肺健脾散结中药配合孟鲁司特钠片、糠酸莫米松鼻用喷雾剂治疗,对照组用孟鲁司特钠片、糠酸莫米松鼻用喷雾剂治疗,共3个疗程,每个疗程为4周。观察治疗前后电子鼻咽镜评分对比,并根据症状积分分析临床疗效。结果治疗组总有效率为91.18%,对照组为83.87%。两组鼻塞、打鼾、张口呼吸、呼吸暂停症状积分治疗后比治疗前减少,两组电子鼻咽镜评分较前相比较明显减少,差异有统计学意义。结论补肺健脾散结法可以明显改善肺脾气虚型儿童腺样体肥大患者临床症状,可提高患儿的生活质量,其疗效优于单纯西药治疗,值得推广。     

鼻用类固醇治疗儿童变应性鼻炎伴腺样体肥大疗效分析

目的 探讨儿童变应性鼻炎(AR)与腺样体肥大的关系, 评价鼻用类固醇治疗儿童变应性鼻炎伴腺样体肥大的疗效。方法 对照组为单纯腺样体生长儿童261例, 其中腺样体肥大190例(72.7%)。观察组为变应性鼻炎伴腺样体生长儿童162例, 其中腺样体肥大110例(67.2%)。两组均给予鼻用类固醇(丙酸氟替卡松喷剂)持续喷鼻3个月后于鼻内镜下复查。结果 对照组并发腺样体肥大构成比为72.7%,观察组并发腺样体肥大构成比为67.2%, 差异无统计学意义(χ²=1.16, P>0.05)。对照组采用鼻用类固醇治疗后有效腺样体体积减少112例(58.9%),观察组有效腺样体体积减小89例(80.9%)(χ²=19.04, P<0.01)。结论 经鼻用类固醇治疗, 变应性鼻炎伴腺样体肥大患儿腺样体体积减小程度较单纯腺样体肥大患儿明显。对变应性鼻炎合并腺样体肥大者可优先考虑应用鼻用类固醇激素。     

Long-term follow-up of children undergoing topical intranasal steroid therapy for adenoidal hypertrophy

BACKGROUND: Encouraging results concerning chronic obstructive nasal symptoms due to adenoid in pediatric population were reported by use of intranasal steroid for short period. Up to now, no data are available about outcomes of such therapy after long-term follow-up. We evaluated the utility of mometasone furoate aqueous nasal spray in children with adenoidal hypertrophy in long-term maintenance therapy. METHODS: All children affected by adenoidal hypertrophy and undergoing successful mometasone treatment for 4 months in a preceding trial were reassessed after a mean follow-up of 28 months. Based on the duration of maintenance therapy and eventual adenoid surgical treatment, three subgroups were identified: (1) children voluntarily suspending maintenance therapy and requiring surgery (Group A); (2) children continuing maintenance therapy but undergoing surgery (Group B); and (3) children continuing maintenance therapy but not undergoing surgery (Group C). Clinical and endoscopic evaluation in each group was compared to the assessment performed after the first 4 months of treatment. RESULTS: Six patients (Group A) voluntarily suspended maintenance therapy and underwent adenoidectomy. Either the overall symptom score or choanal obstruction of this group worsened compared to the previous trial. Adenoidal surgery was performed in another three children (Group B) for ear disease. Chronic obstructive nasal symptoms and adenoid size were unchanged compared to the preceding study. Finally, 12 patients were in Group C. The overall symptom score and choanal obstruction of this group showed a further significant improvement at this stage. CONCLUSIONS: This study describes the first long-term follow-up of children undergoing mometasone furoate aqueous nasal spray treatment for adenoidal hypertrophy. Voluntary suspension of maintenance therapy favors surgery of this disorder, whereas its regular administration may lead to successful results.     

A double-blind randomized placebo-controlled trial of topical intranasal mometasone furoate nasal spray in children of adenoidal hypertrophy with otitis media with effusion

PurposeTo study the effects of topical intranasal mometasone furoate nasal spray for management of otitis media with effusion in children aged 2–12 years with adenoidal hypertrophy and its impact on change in quality of life.MethodA prospective randomized double blind interventional placebo control study was conducted. Hundred patients of endoscopic grade 3 or 4 adenoidal hypertrophy aged 2–12 years were enrolled in this study. Among these sixty two patients had persistent bilateral otitis media with effusion more than three months. These were randomly divided into two groups, group A and group B. Group A received mometasone nasal spray for six months and group B received saline nasal spray for the same period. Patients were evaluated with symptom, pure tone audiometry wherever possible, pneumatic otoscopic examination and tympanogram at 0, 8 and 24 weeks.ResultsResolution of otitis media with effusion in study group (28 out of 30) was significantly higher as compared control group (16 out of 32) (p value 0.0004). A significant improvement in hearing and symptoms was seen in the study group (p < 0.04). Statistically significant change in quality of life was seen with mometasone nasal spray (37.11) as compared to saline nasal spray (11.02) (p value 0.0001).ConclusionMometasone nasal spray appears to be effective for the treatment of otitis media with effusion in patients of adenoidal hypertrophy.     

A randomized controlled trial of mometasone furoate nasal spray for the treatment of nasal polyposis

OBJECTIVE: To evaluate the efficacy and safety of mometasone furoate nasal spray (NS) for the treatment of nasal polyposis. DESIGN: Randomized, double-blind, placebo-controlled, parallel-group, multicenter study. SETTING: A total of 24 centers in 17 countries. PATIENTS: A total of 310 subjects 18 years or older with bilateral nasal polyps. INTERVENTIONS: (1) A 200-microg dose of mometasone furoate NS in the morning and matching placebo in the evening; (2) 200-microg doses of mometasone furoate NS in the morning and evening; or (3) matching placebo in the morning and evening. All 3 regimens were administered as a nasal spray for 4 months. MAIN OUTCOME MEASURES: Primary end points were change from baseline to last assessment in physician-assessed bilateral polyp grade and change from baseline in subject-assessed congestion and/or obstruction score averaged over the first month of treatment. Analysis of variance was used for all efficacy end points except for change in bilateral polyp grade, for which baseline polyp grade was added as a covariate to the analysis of variance model to account for any between-group baseline differences in this variable. RESULTS: Mometasone furoate NS doses of 200 microg administered once or twice daily produced greater reductions in bilateral polyp grade at the end point than placebo, with differences reaching statistical significance with twice-daily dosing (P = .04). Over 1 month, both mometasone furoate NS regimens produced statistically superior improvements from baseline in congestion and/or obstruction score vs placebo (P = .01 for once-daily dosing; P<.001 for twice-daily dosing). The drug was well tolerated. CONCLUSION: Mometasone furoate NS is an effective and well-tolerated treatment for bilateral nasal polyposis in adults, reducing nasal polyp size and symptoms of nasal congestion and/or obstruction.     

Exploring the characteristics of children with obstructive adenoid responding to mometasone fuorate monohydrate: preliminary results

This study aimed at observing the efficacy of mometasone fuorate monohydrate nasal spray on obstructive adenoids in children and identifying the characteristics of responders using a pilot study including children aged 2–11 years, with evidence of more than 50 % obstruction. Allergic rhinitis and nasal obstruction were evaluated on baseline (V0), 6- (V1), and 12-week (V2) visits. Degree of obstruction was evaluated by nasopharyngoscopy at V0 and V2. Subjects received 100 μg mometasone fuorate daily. Results were compared with those of a matching control group. Nineteen children (8 females, 11 males; 2.25–8.50 years old, mean 4.24 years, median 4.00 years) completed treatment and follow-up adequately. There was 58 % reduction in a clinical score assessing the severity of adenoidal obstruction (P < 0.05), 56 % reduction in severity of obstructive symptom (P < 0.05), and 75 % reduction in allergic rhinitis score (P < 0.05) between V0 and V1. No further significant improvement was noticed between V1 and V2. The degree of obstruction dropped from 85 to 61 % as noted on endoscopy (P < 0.05). None in the control group showed spontaneous decrease or resolution of the symptoms. Age of patients, allergic rhinitis score, and severity of the clinical score had no impact on the response parameters. No side effects were observed. Mometasone furoate monohydrate nasal spray appears to be effective in treating children with obstructive adenoids. The effect seems to be independent of the presence of mild intermittent allergic rhinitis, the age of patient, or the severity of symptoms.     

Medical treatment of adenoid hypertrophy with “fluticasone propionate nasal drops”

Background

Adenoid hypertrophy treatment for children is generally planned in accordance with the degree of airway obstruction and related morbidity. If surgical treatment is indicated, the individual risk/benefit analysis of patients should be assessed in terms of anesthetic and postoperative complications. Although there are few alternative treatment options, these may be considered as a nonsurgical approach in less serious cases. Accordingly, studies about intranasal steroid applications under various protocols have been presented.

Study design

The prospective, randomized, placebo-controlled study.

Setting

Tertiary referral center.

Patients and methods

Patients indicated for surgery were randomly divided into two groups. The study group was treated by fluticasone propionate nasal drops (NSD-nasal steroid drops) of 400 μg/day for 8 weeks. The control group was treated by normal saline (NS) in the same way. All the patients were called for follow-up every 4 weeks.

Results

At the end of 8 weeks, statistically significant improvement (p < 0.05) was observed in the NSD treated group compared to the NS treated group in terms of nasal airway obstruction, mouth breathing, speech abnormalities, apnea and night cough. At the end of 8 weeks, the average total symptoms score of the NSD treated group dropped from 13.7 to 2.9 while the NS treated group's score changed from 14.8 to 14.6. After 8 weeks of NSD treatment the initial adenoid/choana (A/C) rate had dropped from 87 to 56% and a total decrease of 35.6% was observed. After 8 weeks of NS treatment the A/C rate dropped from 87 to 85% and a total decrease of 2.2% was observed.

Conclusions

In this study, the effect of fluticasone propionate nasal drops on adenoid hypertrophy is examined for the first time. This method provides an effective alternative to surgical treatment in children with adenoid hypertrophy. With the protocol applied in this study 76% of the patients were eliminated the surgery and removed from the surgical waiting list.     

Olfactory sensitivity in adenoid hyperplasia]

Olfactory sensitivity was assessed in 37 children aged between 5 and 12 years before and after adenectomy. Olfactory detection thresholds for 2-phenylethanol and dimethyldisulphide, as well as the ability to distinguish 8 other odours, were measured using a squeeze bottle test. The results suggest that preoperative olfactory detection thresholds in subjects with severe nasal obstruction attributable to adenoid hypertrophy are higher than in those with less severe nasal obstruction. The olfactory detection thresholds improved after adenectomy in cases with high preoperative nasal obstruction indices. The olfactory detection threshold remained relatively unchanged in cases with less severe adenoid hyperplasia. In contrast, improvement in olfactory discrimination was observed in all children, irrespective of the degree of preoperative nasal obstruction.     

The role of mometasone furoate nasal spray in the treatment of adenoidal hypertrophy in the adolescents: a prospective, randomized, cross-over study

Aim of this work is to find out whether the symptoms attributable to adenoid hypertrophy in adolescents may be treated with intranasal mometasone furoate (MF) application. To learn if adenoid hypertrophy in adolescents may decrease in size with intranasal MF. A prospective, double blind, randomized, cross-over study was conducted in 28 subjects (12–18 years) with adenoidal hypertrophy. Subjects used intranasal MF or placebo for a duration of 6 weeks with a wash out period of 3 weeks. Subjective symptoms and adenoid size were evaluated. At the initiation of the study, there was no significant difference between the mean symptom scores for any of the sinonasal symptoms between the two treatment groups. There was significant improvement in total subjective symptoms (nasal blockage, rhinorrhea, cough, snoring and disruption of quality of life scores) with MF compared with placebo. Analysis of the symptoms separately showed a significant positive effect of MF on all symptoms except for rhinorrhea. Nasal endoscopic evaluation failed to demonstrate any difference in the reduction of the adenoid size between the two groups. MF has significant advantage over placebo for the symptoms attributable to adenoid hypertrophy in adolescents.     

分泌性中耳炎复发的相关因素分析

目的：探讨分泌性中耳炎（otitis media with effusion,OME）复发相关的影响因素。方法分析经鼓膜切开置管术治疗的255例慢性分泌性中耳炎患者的临床资料,其中取出通气管后一年内复发者85例,未复发者170例。对与分泌性中耳炎复发相关的可能因素包括年龄、性别、病程、吸烟环境、反复呼吸道感染、慢性鼻－鼻窦炎、鼻腔结构异常、腺样体肥大或鼻咽淋巴组织增生、乳突气化情况、既往置管手术史、中耳通气管留置时间等进行单因素分析及多因素 Logistic 回归分析。结果单因素分析发现,年龄、反复呼吸道感染（χ2＝22．546,P＝0．000）、慢性鼻－鼻窦炎（χ2＝5．211,P＝0．023）、腺样体肥大或鼻咽淋巴组织增生（χ2＝10．338,P＝0．002）、乳突气化不良（χ2＝15．196,P＝0．000）、通气管留置时间（3～6月）（χ2＝11．347,P＝0．001）对分泌性中耳炎复发的影响有统计学意义。Logistic回归分析显示,小龄、反复呼吸道感染（P＝0．001,OR＝2．992）、腺样体肥大或鼻咽淋巴组织增生（P＝0．021,OR＝2．198）、乳突气化不良（P＝0．000,OR＝3．433）、通气管留置时间（3～6 m）（P＝0．010,OR＝2．237）5个因素对分泌性中耳炎复发的影响有统计学意义。反复呼吸道感染对学龄前、学龄期儿童和青少年复发性分泌性中耳炎影响有显著意义,腺样体肥大或鼻咽淋巴组织增生对学龄前儿童O ME复发的影响有显著意义（P＜0．05）。结论小龄、反复呼吸道感染、慢性鼻－鼻窦炎、腺样体肥大或鼻咽淋巴组织增生、乳突气化不良、通气管留置时间较短可能是导致分泌性中耳炎复发的主要因素。反复呼吸道感染对学龄前、学龄期儿童和青少年的影响较成人更为显著,腺样体肥大对学龄前儿童的影响最为明显。     

Mometasone furoate intranasal spray is effective in reducing symptoms and adenoid size in children and adolescents with adenoid hypertrophy

IntroductionThe use of mometasone furoate (MF) intranasal spray in treating adenoid hypertrophy (AH) has a variable outcome due the different methods of adenoid size evaluation. The aim of our study was to evaluate the effect of MF intranasal spray in children and adolescents with AH using a reliable and consistent endoscopic evaluation.Material and methodA prospective interventional study was conducted. Evaluation took place during the first visit (week 0) and second visit (week 12). Symptoms of nasal obstruction, rhinorrhoea, cough and snoring were assessed, and an overall total symptoms score was obtained. A rigid nasoendoscopic examination using a four-grading system of adenoid size from 1 to 4 was performed. Patients were treated with MF intranasal spray for 12 weeks. Patients’ aged 7–11-years old used 1 spray in each nostril once daily, while patients aged 12–17 used two sprays in each nostril once daily. Reassessment was carried out during the second visit (week 12).ResultsA total of 74 patients was recruited. There were significant improvements from week 0 to week 12 in the symptoms’ score for nose obstruction, rhinorrhoea, cough, snoring including the total nasal symptoms’ score (p < 0.001). AH significantly reduced in size from week 0 (2.89 ± .87) to week 12 (1.88 ± .83) (p < 0.001).ConclusionMF intranasal spray is effective in improving the symptoms attributed to AH as well as reducing the adenoid size. MF intranasal spray is advocated as a treatment option before adenoidectomy is considered.