Role of Intranasal Steroid in the Prevention of Recurrent Nasal Symptoms after Adenoidectomy

Abstract

Background. Intranasal steroid provides an efficient nonsurgical alternative to adenoidectomy for theimprovement of adenoid nasal obstruction. Objective. To demonstrate the role of intranasal steroid in the prevention of adenoid regrowth after adenoidectomy. Methods. Prospective randomized controlled study. Two hundred children after adenoidectomy were divided into 2 groups. Group I received postoperative intranasal steroid and group II received postoperative intranasal saline spray. Both medications were administered for 12 weeks postoperatively. Patients were followed up for 1 year. Followup was done using the nasopharyngeal lateral X-rays, reporting the degree of the symptoms. Results. Significant difference between both groups after 6 months and after 1 year. The intranasal steroid group had significantly lower score after 6 months and after 1 year as regards nasal obstruction, nasal discharge, and snoring than the intranasal saline group. 2 weeks postoperatively, there was no difference between both groups as regards nasal obstruction, discharge, or snoring. As regards lateral radiographs, there was statistically significant difference between both groups 1 year but not 6 months postoperatively. Conclusion. Factors influencing the outcome of intranasal steroids therapy in the prevention of adenoid regrowth have not been identified. However, this treatment may obtain successful results in children to avoid readenoidectomy.

Treatment of hypertrophy of adenoids. Balancing between adenotomy and medication

“…Показано, що застосування ЕКС після аденоїдектомії полегшувало носові симптоми і запобігало рецидиву аденоїдів після операції протягом 1-річного періоду спостереження [90]. Зазначено, що ЕКС зменшують величину аденоїдів і полегшують симптоми обструкції дихальних шляхів і ОСАС [1].…”

Mendengkur pada Anak: kapan waktu yang tepat untuk dilakukan tonsiloadenoidektomi?

“…Pada primary snoring, UARS, HO dan OSAS ringan, pemberian kortikosteroid intranasal selama 4-8 minggu mempunyai efek yang baik (gejala mendengkur berkurang secara nyata). 18 Indikasi TA jika didapat hipertrofi tonsil dan adenoid ditambah dengan klinis yang sering dijumpai pada OSAS, seperti mulut terbuka saat bernapas, suara napas parau, hipertensi, hiperaktif, enuresis, mengantuk pada siang hari (day time somnolence), dan cenderung gizi kurang ke arah buruk. Pada keadaan tersebut dapat dilakukan tindakan TA sebagai tindakan awal dan agresif untuk mencegah terjadinya komplikasi yang lebih berat.…”

“…Respons yang baik terhadap pemberian kortikosteroid intranasal menunjukkan bahwa tindakan TA belum perlu dilakukan karena sumbatan jalan napas berkurang. 16,18 Dalam hal respons terhadap kortikosteroid intranasal tidak berhasil maka perlu dipertimbangkan tindakan TA apabila faktor risiko utama adalah hipertrofi tonsil dan/atau adenoid. Tindakan TA mempunyai angka keberhasilan yang sangat tinggi yaitu 75%-100% tergantung dari ada tidaknya faktor risiko lainnya seperti obesitas atau disproporsi wajah.…”

Effect of topical mometasone furoate on adenoidal lymphoid tissue: a light microscopic study

“…However, treatment with topical nasal steroids has been proposed for mild or moderate enlargement of the adenoids 7 . Steroids have anti-inflammatory and lymphopenic effects that may shrink the adenoidal tissue and improve the nasal airway 8 – 11 …”