Effect of montelukast treatment on adenoid hypertrophy and sleep quality in pediatric patients

Abstract

Adenoid vegetation is part of lymphoid tissue located in the upper respiratory tract. When adenoid tissue becomes hypertrophied, it may cause narrowing of the respiratory tract and complications. Generally, treatment of adenoid hypertrophy is surgical; however, currently reducing the size of adenoid hypertrophy with the leukotriene receptor blocker of montelukast is evaluated among treatment choices apart from surgery. The aim of the study was to assess whether montelukast treatment is an alternative to surgical treatment or not. The study included a total of 50 pediatric patients. Adenoid tissue size was evaluated endoscopically and radiographically. Patients were divided into two groups based on closure of the nasopharynx by adenoid tissue. Group 1 comprised adenoid hypertrophy cases with the choana blocked by less than 50%, with Group 2 comprising children with adenoid hypertrophy and more than 50% closure of the choana. All patients began 5 mg montelukast treatment for 12 weeks. Patients had the pediatric sleep questionnaire applied before and after treatment. Tests and radiographic results were compared. In both groups, it was identified that montelukast treatment had no effect on adenoid tissue size (p=0.286, 0.304, respectively). Contrary to this, patients in Group 1 were identified to have statistically significant improvement in sleep quality with montelukast treatment (p=0.006). In Group 2 patients, there was no such improvement in sleep quality identified (p=0.91). Montelukast treatment increased sleep quality in children with less than 50% obstruction of the choana.