The Role of Intranasal Corticosteroid Therapy in Pediatric Adenoidal Hypertrophy: A Randomized Clinical Trial Study

Abstract

Background: Adenoidal hypertrophy (AH) is a common disorder in pediatric population with severe complications due to nasal air way obstruction. Adenoidectomy is a choice treatment for children with severe symptoms due to AH; however, it is accompanied by several side effects such as complication of surgery and emotional distress. We evaluated the efficacy of intranasal corticosteroid therapy in size and symptoms of Adenoid Hypertrophy especially in atopic patients.
 Methods: In this clinical trial 45 children aged 2 to 14 years old with AH were enrolled. All of them underwent 8-week course of intranasal Fluticasone therapy and their symptoms before and after treatment were scored and compared by questionnaires. Also they were divided into Atopic and non- Atopic groups based on history, physical examination and positive skin prick test. Then the two groups were compared after the treatment according to their response to therapy.
 Results: After 8 weeks’ treatment with intranasal corticosteroid, improvement in all symptoms score of AH including (Snoring, Sleep Apnea, Mouth breathing and Nasal congestion) was statistically significant (P = 0.000). The improvement in clinical symptoms of AH after treatment was observed in 92% of atopic patients in comparison with non-atopic patients was 50%, which was also statistically significant (P = 0.024).
 Conclusion: Our study demonstrated that 8-week intranasal corticosteroid was associated with a decrease in size of AH and all symptoms of obstruction. As a result, it can be suggested that intranasal corticosteroid therapy can prevent adenoidectomy especially in atopic patients.