Abstract
Background: The purpose of this study is to analyse the long-term effects of a 12-week course of topical steroids on adenoid size and its mucus using endoscopy and on middle ear effusion measured by tympanometry. Methods: The study presents an endoscopic choanal assessment of the change in adenoid size (adenoid to choanae ratio, A/C ratio) and its mucus coverage in 165 children with Grade II and III adenoid hypertrophy three to six months after finishing a 12-week course of intranasal steroid treatment with mometasone furoate. Additionally, tympanometry was performed to measure middle ear effusion. Changes in the tympanograms were analysed. Results: The mean A/C ratio before treatment was 65.73%. Three to six months after finishing a 12-week course of intranasal steroid treatment, the mean A/C ratio decreased to 65.52%, although the change was not statistically significant (p = 0.743). There was no change in adenoid mucus according to the MASNA scale before and three to six months after the end of the steroid treatment (p = 0.894). Long-term observations of tympanograms before and three to six months after the end of the treatment did not show improvement (p = 0.428). Conclusions: The results indicate that there was no effect of topical steroids on adenoid size, its mucus and otitis media with effusion (OME) three to six months after finishing a 12-week course of treatment. In the light of performed study, decision of adenoidectomy and tympanostomy should not be procrastinated.
Highlights
Published: 20 January 2022Nasal obstructions, recurrent upper respiratory tracts infections, mouth breathing, persistent rhinorrhoea, snoring, nasal voice and recurrent otitis media in preschool children suggest enlarged adenoids and incline pediatricians to refer the patient to an ear, nose and throat (ENT) specialist [1]
Because seasonality may influence adenoid mucus coverage and tympanometry, for detailed analyses patients was divided to two subgroups of thermal sequence examination, in which 85 children were first examined in winter and in summer, and the remaining 80 children were first examined in summer and in winter [18]
The results indicate that there was no effect of intranasal mometasone furoate on adenoid size, its mucus and otitis media with effusion (OME) three to six months after finishing a 12-week course of treatment
Summary
Published: 20 January 2022Nasal obstructions, recurrent upper respiratory tracts infections, mouth breathing, persistent rhinorrhoea, snoring, nasal voice and recurrent otitis media in preschool children suggest enlarged adenoids (pharyngeal tonsil) and incline pediatricians to refer the patient to an ear, nose and throat (ENT) specialist [1]. The percentage of adenoid hypertrophy in young children admitted to ENT outpatient clinics because of nasal obstructions is estimated to be 57.7% [2]. Upon confirmation of an enlarged adenoid and its symptoms, conservative treatment with the use an intranasal steroid and saline irrigation should be applied [3,4,5]. The study concerning on number of eosinophils of allergic rhinitis children demonstrate that combined steroid and saline treatment improves the efficacy of treatment [5]. Almost 90% of children with adenoid hypertrophy and adenoid symptoms undergo surgery in the two-year period after the initial diagnosis [6]. Effectiveness of adenoid surgery in children with
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