Abstract
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.
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References
Bitar MA, Berjawi G, Youssef M, Fuleihan N (2009) How frequent is adenoid obstruction? Impact on the diagnostic approach. Pediatr Int 51(4):478–483
Bitar MA, Rahi A, Khalife M, Madanat LM (2006) A Suggested Clinical Score to Predict the Severity of Adenoids Obstruction. Eur Arch Otorhinolaryngol 263(10):924–928
Ying M (1988) Immunological basis of indications for tonsillectomy and adenoidectomy. Acta Otolaryngol Stockh. 454:279–285
Ikinciogullari A, Dogu F (2002) ikinciogullari A, Egin Y, Babacan E. Is immune system influenced by adenotonsillectomy in children? Int J Pediatr Otorhinolaryngol 66(3):251–257
Linder-Aronson S, Adenoids (1970) Their effect on mode of breathing and nasal airflow and their relationship to characteristics of the facial skeleton and the dentition. A biometric, rhino-manometric and cephalometro-radiographic study on children with and without adenoids. Acta Otolaryngol Suppl Stockh. 265:1–132
Bachert C, van Cauwenberge P, Khaltaev N, World Health Organization (2002) Allergic rhinitis and its impact on asthma (ARIA) in collaboration with the World Health Organization. Allergy 57(9):841–855
Torrey J, Reese M (1945) Initial aerobic flora of newborn infants. AJDC 69:208–214
Mackowiak P (1982) The normal microbial flora. N Engl J Med 307:83–93
Brodsky L, Koch J (1993) Bacteriology and immunology of normal and diseased adenoids in children. Arch Otolaryngol Head Neck Surg 119:821–829
Vandenberg SJ, Heatley DG (1997) Efficacy of adenoidectomy in relieving symptoms of chronic sinusitis in children. Arch Otolaryngol Head Neck Surg 123(7):675–678
Linder TE, Marder HP, Munzinger J (1997) Role of adenoids in the pathogenesis of otitis media: a bacteriologic and immunohistochemical analysis. Ann Otol Rhinol Laryngol. 106(8):619–623
Berlucchi M, Salsi D, Valetti L, Parrinello G, Nicolai P (2007) The role of mometasone furoate aqueous nasal spray in the treatment of adenoidal hypertrophy in the pediatric age group: preliminary results of a prospective, randomized study. Pediatrics 119(6):e1392–e1397
Cengel S, Akyol MU (2006) The role of topical nasal steroids in the treatment of children with otitis media with effusion and/or adenoid hypertrophy. Int J Pediatr Otorhinolaryngol 70(4):639–645
Demain JG, Goetz DW (1995) Pediatric adenoidal hypertrophy and nasal airway obstruction: reduction with aqueous nasal beclomethasone. Pediatrics 95(3):355–364
Chadha NK, Zhang L, Mendoza-Sassi RA, César JA (2009) Using nasal steroids to treat nasal obstruction caused by adenoid hypertrophy: does it work? Otolaryngol Head Neck Surg 140(2):139–147
Goldbart AD, Veling MC, Goldman JL, Li RC, Brittian KR, Gozal D (2005) Glucocorticoid receptor subunit expression in adenotonsillar tissue of children with obstructive sleep apnea. Pediatr Res 57(2):232–236
Schenkel EJ, Skoner DP, Bronsky EA, Miller SD, Pearlman DS, Rooklin A et al (2000) Absence of growth retardation in children with perennial allergic rhinitis after one year of treatment with mometasone furoate aqueous nasal spray. Pediatrics 105(2):22
Acknowledgments
The authors and sponsors would like to thank and acknowledge the valued contribution of the following primary health care physicians: Bassem Abu Merhi, MD; Zeinab Tahsh, MD; Mohamed Arab, MD; Bilan Yaman, MD; and Ali El-Ghoul, MD. This study was sponsored by Schering-Plough Levant, a subsidiary of Schering-Plough pharmaceutical.
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L. Mahfoud, J. Nassar and R. Dana are currently in private practice in Lebnaon. Trial registration number: P04367; Clinical Trials.gov Identifier: NCT00553891.
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Bitar, M.A., Mahfoud, L., Nassar, J. et al. Exploring the characteristics of children with obstructive adenoid responding to mometasone fuorate monohydrate: preliminary results. Eur Arch Otorhinolaryngol 270, 931–937 (2013). https://doi.org/10.1007/s00405-012-2155-8
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DOI: https://doi.org/10.1007/s00405-012-2155-8