Treatment Of Adenoid Hypertrophy Research Articles

Effects of oral cysteine leukotriene receptor antagonist-montelukast on adenoid lymphoid tissue: a histopathological study under light microscope.

Background: Adenoidal hypertrophy (AH) is one of the most common causes of upper airway obstruction in children. Drug and surgical treatment are the typical treatment of AH. The study on the inflammatory mechanism of AH in children provides a new idea for preoperative intervention and non-surgical treatment with anti-inflammatory drugs such as montelukast sodium (a cysteine leukotriene receptor antagonist). The aim of this study is to evaluate the effect of montelukast sodium on adenoidal lymphoid tissue pathology in children with AH under light microscope. Objective: To study whether there is any change in pathology of the adenoidal lymphoid tissue under the light microscope compared with the control group in children with moderate to severe simple AH treated with montelukast sodium for 1month before operation. Materials and methods: Twenty patients (8 males, 12 females, 3-8 years old) with moderate to severe AH who were prepared for surgical treatment were selected. All the patients were examined by Nasopharyngeal CT and hemocyte analysis before operation. 20 subjects were randomly divided into two groups: One group was given montelukast chewable tablets 5mg/d, qn, for 4 weeks; The control group was given placebo 5mg/d, qn, for 4 weeks. After 4 weeks, the adenoids were removed and examined histopathology. Results: Compared with the control group, the number of lymphocytes in the blood cell analysis of the study group was significantly reduced, with a statistically significant difference (p < 0.05). And the number of germinal centers in adenoid tissue of the study group was relatively reduced, no small cyst was found in the epithelium, and the degree of inflammatory cell infiltration was reduced, with a statistically significant difference (p < 0.05). Conclusion: Montelukast can reduce the number of reactive cells, the number of lymphocytes in blood cells and blood vessels in adenoid lymphoid tissue, which can provide a new idea for preoperative intervention and non-surgical treatment of adenoid hypertrophy in children. However, this is only a pilot study and a longer treatment period is needed to assess the long-term effects of montelukast sodium on adenoid lymphoid tissue. Clinical Trial Registration: www.Chictr.org.cn, identifier ChiCTR2300075040.

Evaluation Value of Allergy in Adenoid Hypertrophy Through Blood Inflammatory Cells and Total Immunoglobulin E.

Objective: Previous reports have indicated the close association of allergy with adenoid hypertrophy (AH). The aim of this study was to evaluate whether the inflammatory cells and total immunoglobulin E (IgE) in blood could be useful in the diagnosis of allergy in AH. Methods: Two hundred thirty-four children who underwent adenoidectomy were retrospectively enrolled in this study. Blood routine parameters were recorded, and total IgE as well as specific IgE (sIgE) of common allergens were tested perioperatively. The diagnostic utility of blood inflammatory cells and total IgE compared with serum sIgE testing was assessed. Results: In our study, 35.47% of AH children were atopic. Dermatophagoides farinae (d2), Dermatophagoides pteronyssinus (d1), and mold (mx2) were the most common sensitizing allergens. Significantly elevated eosinophil count, eosinophil to lymphocyte value, and total IgE were found in allergic AH children. As a result of receiver operating characteristic analysis, systemic total IgE could be a method to diagnose allergy in AH with a cutoff value of 46.55 and higher (area under curve [AUC] = 0.837; P < 0.001). Peripheral eosinophil count and eosinophil to lymphocyte were also able to predict positive allergy test result in AH children, with a cutoff value of 0.295 (AUC = 0.721; P < 0.001) and 0.082 (AUC = 0.685; P < 0.001), respectively. Conclusion: The presence of allergy can be distinguished by looking at peripheral total IgE and/or blood eosinophils in AH, which will guide us to the precise treatment of AH and also reduce the cost considerably.

Eustachian Tube Dysfunction in Children with Adenoid Hypertrophy: The Effect of Intranasal Azelastine-Fluticasone Spray Treatment on Middle Ear Ventilation and Adenoid Tissue.

Eustachian tube dysfunction (ETD) is frequent in children with adenoid hypertrophy (AH). Although the most common treatment of AH is surgical removal of adenoid tissue, numerous studies have reported the efficacy of intranasal steroids. The effects of the intranasal steroid and azelastine combination on AH and ETD have not been reported before. In this study, we tried to determine the effects of 3-month intranasal Azelastine-Fluticasone dipropionate combination (Aze-Flu) treatment in children with ETD and AH. 100 children who had open mouth sleep, snoring, and sleep apnea and were diagnosed with AH and ETD participated in this study. The mean age was 7.73 ± 2.37 (4-14 years). The rates of adenoid tissue hypertrophy and choanal occlusion were evaluated using a rigid pediatric nasal endoscope and reassessed after 3 months of Aze-Flu nasal spray treatment. The function of the Eustachian tube (ET) was evaluated before and after medical treatment using the Eustachian tube score, the Eustachian dysfunction test-7 (ETS-7) and tubomanometry (TMM). The results were evaluated in 100 patients with AH and ETD. The adenoid tissue to choana rate was 82% before treatment and decreased to 37% after treatment. The ETS-7 test score was 6.36 before treatment and increased to 9.72 at the end of 3 months. Both the regression of the adenoid tissue and the improvement in the Eustachian function scores were statistically significant (p < 0.05). AH significantly increases the frequency of ETD. In this study, it was observed that Aze-Flu treatment was significantly effective in both regression of the adenoid tissue and Eustachian tube dysfunction. We believe that it can be applied as an initial therapy in children with AH and associated ETD.

Risk factors and antibiotic sensitivity of aerobic bacteria in Chinese children with adenoid hypertrophy

BackgroundBacterial infection of adenoid is currently considered to be an important cause of adenoid hypertrophy (AH) in children. Although several bacteriology studies on adenoid diseases have been reported, the aerobic bacterial study regarding risk factors and antibiotic sensitivity of AH in Chinese children is lacking. This study aims to investigate the risk factors for aerobic bacterial colonization of AH in Chinese children and to elucidate aerobic bacterial profiles and antibiotic sensitivity.MethodsSamples were collected from the adenoid core and surface tissue of 466 children undergoing adenoidectomy. Aerobic cultures and antibiotic sensitivity were observed. The risk factors for bacterial colonization of adenoid were analyzed statistically.ResultsA total of 143 children could be detected opportunistic pathogens in adenoid surface and/or core tissue, with a carriage rate of 30.7%. The presence of chronic rhinosinusitis, tonsillar hypertrophy and adenoidal size were the risk factors for aerobic bacterial colonization of adenoid in univariate analysis. Multivariate analysis showed that chronic rhinosinusitis and tonsil hypertrophy were significant variables associated with the aerobic bacterial colonization. The most frequently isolated aerobic bacteria were Haemophilus influenzae, followed by Staphylococcus aureus and Streptococcus pneumoniae. There was no statistically significant difference in bacterial species between the adenoid surface and core. The above common bacteria were more sensitive to cephalosporins and quinolones antibiotics, and significantly resistant to penicillin antibiotics and non-β-lactamase inhibitors.ConclusionOur results provide recent aerobic bacterial profiles for AH among Chinese children and confirm the risk factors and antibiotic sensitivity. This study contributes to understanding the role of different risk factors in the development of AH and will be helpful to the treatment of AH among Chinese children.

Efficacy of Topical Azelastine and Fluticasone Dipropionate Combination in Children With Adenoid Hypertrophy.

Adenoid hypertrophy (AH) is one of the common childhood diseases. Surgical and non-surgical treatment of AH in children is planned according to the severity of symptoms and associated complications. In recent years, treatment methods with intranasal sprays have been reported quite frequently in uncomplicated cases. We aim to evaluate the effectiveness of a new combination of azelastine - fluticasone (AZE-FLU) (137mcg azelastine and 50mcg fluticasone) nasal spray in children with uncomplicated AH. Sixty-five children diagnosed with AH were included in the study. The mean age of the children was 7.42 ± 2.26 (4-13years). The cohort consisted of 29 males and 36 females. All children were evaluated clinically and endoscopically. AZE-FLU nasal spray was applied to both nostrils twice a day for three months. Adenoid/choana ratio and symptom scores were evaluated before treatment and at the end of the 12th week. At the end of 24weeks of AZE-FLU application, there was a statistically significant decrease in both adenoid/choana ratio and symptom scores. While the initial adenoid/choana (A/C) score was 3.57 ± 0.58, it decreased to 1.74 ± 0.61 following treatment. A dramatic decrease in total symptom scores was observed. The total symptom score average was 15.63 ± 1.28 before treatment, while it was 2.31 ± 1.4 after the treatment with the difference being statistically significant (P < .01). In this study, the effectiveness of AZE-FLU nasal spray on AH was investigated for the first time. This treatment provides an effective alternative to the surgical approach in children with uncomplicated adenoid hypertrophy. Using this protocol, 96% of patients were removed from the surgery list. is IV.

Exploring the Mechanism of Pericarpium Citri Reticulatae and Fritillaria Thunbergii in the Treatment of Adenoid Hypertrophy Based on Network Pharmacology and Molecular Docking

Exploring the Mechanism of Pericarpium Citri Reticulatae and Fritillaria Thunbergii in the Treatment of Adenoid Hypertrophy Based on Network Pharmacology and Molecular Docking

Clinical Study on the Treatment of Adenoid Hypertrophy in Children with Pneumatic Water Mist Nasal Washer

Clinical Study on the Treatment of Adenoid Hypertrophy in Children with Pneumatic Water Mist Nasal Washer

The P.E.A.N.U.T. Method: Update on an Integrative System Approach for the Treatment of Chronic Otitis Media with Effusion and Adenoid Hypertrophy in Children

Background and objectives: Based on our previous single-center study on optimization of treatment of chronic otitis media with effusion (COME) and adenoid hypertrophy (AH) in children using a noninvasive system approach to lower the necessity of antibiotics, analgesic use, and surgical interventions, we proceeded to perform a multicenter investigation in an outpatient setting. The purpose of the previous prospective study in 2013–2015 was to compare outcomes in the treatment of COME and AH using the noninvasive multimodal integrative method (IM) versus conventional treatment practice (COM). Materials and Methods: In this paper, we retrospectively analyze the data of patients treated with the integrative method between 2017 and 2020 in a multicenter setting and compared the outcomes with data from 2013–2015 in order to evaluate generalizability. In both periods, all eligible and willing participants were included and treated with the IM protocol under real-life conditions. The treatment involved pneumatization exercises, education, an antiallergic diet, nasal hygiene, useful constitutional therapy, and thermal interventions (P.E.A.N.U.T.). A total of 48 versus 28 patients, aged 1–8, were assessed, presenting with COME and AH, with moderate to severe hearing impairment at entry. Results: The significant improvement found in both audiometric measures (intact hearing) and tympanometric measures (normal A-type curve) was similar in both datasets with respect to conventional treatment. The new data confirms that the P.E.A.N.U.T. method results in a significant reduction of antibiotics, analgesic use, and surgical interventions. Conclusion: In this multicenter trial, we confirm the effectiveness of the noninvasive system approach for the treatment of COME in lowering the need for antibiotics and analgesic use and elective surgery. This could be especially important with respect to a generally observed increase in antibiotic resistance. The method is easy to perform in different clinical settings and is effective, safe, and well-tolerated.

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

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.

Результаты лечения ронхопатии и синдрома обструктивного апноэ сна у детей с гипертрофией аденоидных вегетаций

Introduction. There are various sleep disorders that are striking and depressing at the same time in their diversity. One of the urgent problems that modern medicine is working on is problems with breathing during sleep, including obstructive sleep apnea syndrome (OSAS). The prevalence of this disease in children ranges from 1.2 to 5.7%. Adenotomy is an absolute indication for children with OSAS and adenoid hypertrophy. Aim. To study the frequency of occurrence of the OSAS in patients admitted to their hospital otorhinolaryngological department of Rauhfus Children’s Municipal Multi-Specialty Clinical Center of High Medical Technology for the planned surgical treatment of adenoid hypertrophy; to assess the effect of adenotomy on the course of OSAS in children. Materials and methods. 42 children aged from 4 to 12 years were examined; all patients underwent computer-based pulse oximetry, rhinomanometry, and nasopharyngeal endoscopy. Results. After adenotomy, nasal patency in children improved significantly: from 289.26 ml/s to 467.00 ml/s; the mean night saturation and desaturation nadir values in children during treatment improved from 97.31 to 97.68% and from 87.58 to 91.52%, respectively; sleep apnea syndrome was detected in 88% of all patients; 1 month after adenotomy, in 66.67% of the examined children OSAS was not detected. Conclusion. Improvement of nasal breathing after adenotomy, confirmed by rhinomanometry data, contributes to improved sleep, as evidenced by the results of computer-based pulse oximetry.

Role of mometasone furoate nasal spray versus saline nasal spray in treatment of adenoid hypertrophy: a prospective, randomized study

&lt;p class="abstract"&gt;&lt;strong&gt;Background: &lt;/strong&gt;Adenoid hypertrophy is a common disorder in the paediatric population, presenting with multiple signs and symptoms ranging from nasal obstruction to obstructive sleep apnoea. Most common symptom is usually nasal airway obstruction. This prospective, randomized study aims to evaluate the efficacy of mometasone furoate spray in reducing size and clinical symptoms in patients with adenoid hypertrophy compared to saline spray.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; 60 patients in the age group of 3-11 years were enrolled in the study. Five symptoms were included that were hypo nasal speech, snoring, night cough, open mouth breathing and nasal obstruction which were scored as never=0, mild (sometimes)=1, moderate (less than 50% of times)=2, and severe (constant)=3. Diagnosis of adenoid hypertrophy was made on basis of nasal endoscopy.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Significant improvement was seen in individual as well as overall symptom score in group A as compared to group B after 8 weeks of treatment (p&amp;lt;0.001). There was significant improvement in mean adenoid grade as per nasal endoscopy at 8 weeks post therapy (p&amp;lt;0.001) which was not seen after 4 weeks of therapy.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusion:&lt;/strong&gt; Intranasal steroid sprays have good role in decreasing the symptoms of adenoid hypertrophy and has reduced number of adenoidectomies required. The long-term effects as well as optimal duration of therapy is still controversial and needs to be studied further.&lt;/p&gt;

STUDY THE CLINICAL FEATURES, TYMPANOMETRY AND EVALUTE THE TREATMENT RESULTS ADENOIDECTOMY

Objective: Determined the clinical features, tympanometry of children who have adenoid hypertrophy operated and evalute the treatment reults adenoidectomy. Material and method: 56 patients were diagnosed adenoid hypertrophy, who have tympanometry operated adenoidectomy at Hue University of Medicine and Pharmacy. Methods are cross sectional and propective studies. Results: Percentage of male (64.3%), female (35.7%). The most common age group is &gt; 3-6 years old (46.4%). Main reason for being hospitalized is nasal discharge (48.2%). Funtional symtoms: nasal discharge (98.2%), nasal obstruction (96.4%). Endoscopy: adenoids grade 3 (53.6%), adenoids grade 2 (26.8%), adenoids grade 4 (14.3%), adenoids grade 1 (5.3%). 33% tympanograme type A, 27.7% tympanograme type C, 26.8% tympanograme type B, 12.5% tympanograme type As. After 6 weeks, results through funtional symtoms: nasal discharge (14.3%), nasal obstruction (8.9%). There aren’t adenoids grade 3 and 4, tympanometry in 90 ears without tympanostomy tube, 83.4% tympanograme type A, 8.9% tympanograme type C, 4.4% tympanograme type As, 3.3% tympanograme type B. Conclusions: Treatment of adenoid hypertrophy by adenoidectomy have good result about clinical and tympanometry. Key words: adenoid hypertrophy, tympanometry

Meta-analysis of Chinese medicine in the treatment of adenoidal hypertrophy in children.

To evaluate the efficacy and safety of Chinese medicine in the treatment of adenoid hypertrophy in children. Screening standard articles, extracting relevant data from meta-analysis, were analyzed by Revman5.1 software, by searching PubMed, Medline, VIP, Wan Fang and Chinese HowNet database 2006-2016 in traditional Chinese medicine treatment of children with adenoid literature. 206 articles met the inclusion criteria, of which ten were selected and included in the meta-analysis, and there were 803 patients. The results showed that the remission rate of the Chinese medicine treatment group was better than that of the Western medicine group. The combined effect of the amount of OR 2.06, 95% Cl (1.45, 2.96) and the combined effect of the amount of the test Z = 4.12, P < 0.00001 showed the recurrence of the disease was lower in traditional Chinese medicine treatment group than the Western medicine group. The combined effect of the amount of OR 3.05, 95% Cl (2.11, 4.56) and the combined effect of the amount of the test Z = 5.86, P < 0.00001 showed the total effective rate is high in the traditional Chinese medicine treatment group than the Western medicine group. The difference between the combined effect of the amount of OR 2.79, 95% Cl (1.78, 5.03) and the combined effect of the amount of the test of Z = 4.54, P < 0.00001 was statistically significant, which showed the treatment effect of Chinese medicine group is obviously better than the Western medicine group. The use of Chinese medicine for the treatment of children with adenoid hypertrophy has good clinical efficacy.

Comparison of effects of nasal endoscopic adenoid body excision and conventional adenoid body shaving in the treatment of adenoid hypertrophy

Objective To compare the effect of adenoidectomy with adenoidectomy under nasal endoscope in the treatment of adenoid hypertrophy. Methods 120 cases with adenoid hypertrophy were selected as the research subjects.The patients were randomly divided into two groups by random number table, and the control group(n=60) was treated with routine adenoidectomy.The surgical treatment of the observation group(n=60) was performed under nasal endoscope.Surgical treatment, surgery related indicators(operative time, the average amount of bleeding, hospitalization time and the incidence of postoperative complications) were compared between the two groups.Before and after operation, acoustic rhinometry examination of nasopharynx was used to detect the smallest cross-sectional area and compared. Results In the observation group, the operation time, the average amount of bleeding, hospitalization time and incidence rate of postoperative complication were (5.32±2.05)min, (51.05±8.26)mL, (8.50±2.50)d, 15.00%, respectively, which in the control group were (8.56±2.68)min, (78.45±10.15)mL, (12.00±3.50)d, 36.67%, respectively, there were significant differences between the two groups(t=7.44, 15.98, 6.30, χ2=7.35, all P<0.05).12 months after surgery, the nasal minimal cross-sectional area of nasal pharynx in the observation group was (1.99±0.51)cm2, which of the control group was (1.81±0.48)cm2, there was significant difference between the two groups(t=3.99, P<0.05). Conclusion Compared with conventional adenoidectomy, endoscopic adenoidectomy in the treatment of adenoid hypertrophy has good clinical curative effect, less bleeding, shorter operative time and less postoperative complications and other advantages, it is worthy of promotion. Key words: Adenoidal hypertrophy; Adenoidectomy; Endoscopy; Child

Clinical observation of mometasone furoate nasal spray combined with montelukast sodium in the treatment of adenoid hypertrophy in children

Objective:To study the clinical effect of mometasone furoate nasal spray combined with montelukast in the treatment of adenoid hypertrophy in children.Method:One hundred and thirty eight cases with adenoid hypertrophy were randomly divided into two groups, 69 cases in each group; the control group were treated with mometasone furoate nasal spray alone; the observation group were treated with mometasone furoate combined with oral montelukast. Adenoid nasopharynx ratio (A/N), and the proportion of overall recurrence after treatment of nasal obstruction were compared, also with snoring, mouth breathing rate, life quality score before and after treatment in the two groups, and finally compared the clinical total effective ratio.Result:Compared with before treatment, A/N of two groups of patients were significantly decreased, and the observation group decreased more significantly, the difference between the two groups was significant (P< 0.05); nasal obstruction, snoring, mouth breathing rate of observation group were significantly lower than the control group, and the recurrence rate also lower than the control group, the difference was statistically significant (P< 0.05). The quality of life scores, sleep disorder scores, physical status score and daily function score in the two groups were significantly decreased after treatment, and in observation group the three scores were decreased more significantly, the difference between the two groups was statistically significant (P< 0.05). The total efficiency of the observation group was 94.1%, which was statistically higher than the control group (79.4%, P< 0.05).Conclusion:The clinical efficacy of mometasone furoate nasal spray combined with montelukast in the treatment of adenoid hypertrophy in children is significant, which can effectively reduce the adenoid nasopharynx ratio, improve the symptoms of snoring, mouth breathing, nasal congestion, improve the quality of life of patients, and the effective ratio was higher than single drug treatment, which was worthy to apply on clinic.

Adenoidectomy: current approaches and review of the literature.

Adenoid is a secondary lymphoid organ located in the nasopharynx. Due to its location, it plays an important role in the host defense of the upper respiratory tract. Immunoglobulin G3 and immunoglobulin A1 antibodies are prevalent antibodies in the adenoid tissue. Adenoidal hypertrophy is a common condition in children causing symptoms such as mouth breathing, nasal discharge, snoring, sleep apnea, and hyponasal speech. It also plays a role in the pathogenesis of rhinosinusitis, recurrent otitis media, and otitis media with effusion. Currently, adenoidectomy is one of the most commonly performed pediatric surgical procedures worldwide. Although there is still poor evidence in the literature, recurrent upper respiratory infections, otitis media with effusion, and obstructive sleep apnea syndrome are considered to be the main indications of adenoidectomy. Adenoidectomy can be carried out with several techniques and instruments. Although rare, surgery possesses some risks and may cause emotional distress both for the patient and the family. Non-surgical treatments such as intranasal steroids are also used in the treatment of adenoid hypertrophy. In this review, we discuss the current literature on the adenoid function, adenoidectomy indications, and treatment of adenoid hypertrophy.

The Efficacy of Mometasone Furoate Nasal Spray in the Treatment of Adenoidal Hypertrophy in Children

Objectives: Realize whether the adenoid size and severity of chronic nasal obstruction symptoms may decrease with intranasal mometasone furoate application in children affected with adenoidal hypertrophy. Methods: Forty children with severe adenoidal hypertrophy (aged between 4-12 years) were recruited between August 2012 and April 2013 in a prospective randomized clinical trial. Primary nasal endoscopy showed more than 75% choanal obstruction in all patients. Subjects were randomly divided into 2 groups. The study group (n = 20) underwent mometasone nasal spray treatment (100 micrograms per nostril every 12 hours) for 4 weeks, and the control group (n = 20) received saline solution nasal spray as placebo in the same manner. Adenoid size and subjective symptoms were evaluated and compared between the 2 groups. Results: At the start of the experiment, there was no significant difference in the mean scores for any of the subjective symptoms (nasal obstruction, snoring, mouth breathing) between the 2 treatment groups. At the end of 4 weeks, statistically significant improvement was observed in total subjective symptom scores with mometasone treatment compared with placebo ( P &lt; .05). A significantly greater number of patients in the study group showed a reduction in adenoid size compared with the control group (70% versus 20%, P = .001). Conclusions: Treatment with mometasone furoate nasal spray causes a substantial improvement in nasal obstruction symptoms and reduction in size of adenoid in children with adenoidal hypertrophy and may obviate the need for surgery in these patients.

Nonsurgical Radiofrequency Volumetric Reduction of Adenoidal Hypertrophy

Objectives: Adenoidal hypertrophy (AH) is the most common cause of pathologic mouth breathing in children. Medical treatment of adenoid hypertrophy includes treatment of allergies, nasal sprays, and antibiotics. However, in some cases AH continues to produce symptoms despite maximal medical therapy. Potential risks of anesthesia and complications of surgical procedures have led to the promotion of non-surgical alternatives. During the past 3 years, advances in expertise and technology led to the new advent of using office based setting for nonsurgical procedures by the author as an innovative method for treatment of AH. Methods: Sixty five children who were definitive candidates for surgical adenoidectomy were managed with radiofrequency treatment under endoscopy control without any need of general anesthesia. The age range was between 4 and 15. All children underwent direct endoscopic examination of adenoid before and after procedure. Results: The period of follow-up was from 2 to 32 months. Patients experienced different degrees of improvement after nonsurgical procedure, according to a researcher-based questionnaire. The results were impressive for some parents because of marked improvement by very simple procedure as compared to surgery. Conclusions: Nonsurgical radiofrequency reduction of adenoid size has multiple advantages: excellent magnified view of adenoid area, accurate reduction of central obstructing part of adenoid, nonbleeding, evaluation and treatment of other nonadenoid obstructing problems, complete preservation of normal nasopharyngeal structures, no general anesthesia, no operating room stress, no hospitalization, high safety, no complications, and better patient tolerance using this fast and easy procedure.

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.

The Role of Proton Pump Inhibitors in Adenoid Hypertrophy in Children

To establish the efficacy of proton pump inhibitors (PPI) in the treatment of adenoid hypertrophy in children. Randomized controlled double-blinded clinical trial. Forty children, aged 2 to 12 years, with adenoid hypertrophy fulfilling the inclusion and exclusion criteria. Patients were randomly allocated into 2 groups: one to be treated with oral Losec MUPS for a period of 2 months (treatment group) and the other to be given a low-dose vitamin C tablet for the same period (control group). The patients were reviewed on 2 occasions during the 2-month study period, during which endoscopy was performed to examine the adenoid glands to assess their size and the larynx to assess signs of reflux disease. Examination of tonsillar size was also performed. There was a significant reduction in adenoid size in the treatment group, but the control group also demonstrated a significant reduction in adenoid size. Comparison between the 2 groups in terms of adenoid grade change between the first and second visits did not reveal any significant statistical difference. The results of this study do not demonstrate any efficacy of PPIs for adenoid hypertrophy in children, and these drugs should not be used for this purpose.