Exploring the characteristics of children with obstructive adenoid responding to mometasone fuorate monohydrate: preliminary results

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.

Role of mometasone furoate aqueous nasal spray for management of adenoidal hypertrophy in children

“…Similar objective observations of a reduction in adenoid size pre-and post-treatment have been reported by most other relevant studies. 7,10,11,[13][14][15] However, in one study there was no significant reduction in adenoid size associated with either beclomethasone or saline nasal spray treatments. 12 • This prospective, randomised, double-blind study comprised 100 children aged 2-12 years • Six months usage of mometasone nasal spray was effective in treating children with symptomatic obstructive adenoids • Six months of treatment with saline nasal spray also reduced symptom scores; however, no significant reduction in adenoid size was observed • Mometasone nasal spray improved quality of life • We advocate six months usage of mometasone nasal spray for obstructive adenoids to achieve a desirable outcome • Mometasone nasal spray can be considered an alternative to surgical intervention for patients with obstructive symptoms due to adenoid hypertrophy…”

“…Most previous studies have used a flexible nasopharyngoscope for this purpose. 7,10,11,[13][14][15][16] In our study, decongestion of the nose was required in only 12 of 200 nasopharyngoscopy procedures (6 per cent). Decongestion of the nose is thought to be a confounding variable and can result in false positive improvement post-treatment.…”

“…These findings are comparable to those of most other relevant studies. 7,10,13,14,16 However, one study reported no statistically significant reduction in symptom scores (compared with a placebo group) following beclomethasone treatment. 12 In our study, we observed statistically significant improvements in symptom scores associated with saline nasal spray treatment, despite no significant reduction in the size of the adenoids.…”

“…Previous studies have used mometasone nasal spray in a dose of 100 μg per day for a variable period, ranging from 40 days to 4 months and 10 days. 7,[13][14][15] Our series is among the largest series employing mometasone nasal spray for the treatment of adenoidal hypertrophy. Unlike previous studies, we examined the changes in quality of life post-treatment.…”

Combination of mometasone furoate and oxymetazoline for the treatment of adenoid hypertrophy concomitant with allergic rhinitis: A randomized controlled trial

“…In the past two decades, the use of topical nasal steroids has brought significant improvement for AH patients, and thus many children have avoided adenoidectomy1819202122. In 1995, Demain and Goetz described the first successful use of beclomethasone for AH in paediatric patients with a 29% decrease in the A/C ratio on average5.…”