Systematic review and meta-analysis of randomized controlled trials on the role of mometasone in adenoid hypertrophy in children

Chohan, Alisha; Lal, Avtar; Chohan, Karan; Chakravarti, Arunabha; Gomber, Sunil

doi:10.1016/j.ijporl.2015.07.009

Cited by 68 publications

(66 citation statements)

References 22 publications

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“…A meta-analysis also showed that mometasone nasal spray significantly reduced the size of adenoid compared with the control group 27. This mechanism may contribute to the therapeutic efficacy of budesonide in the management of AH in children, and the responders may be more sensitive to the hormone receptor.…”

Section: Discussionmentioning

confidence: 90%

Decreased frequency of adenoidectomy by a 12-week nasal budesonide treatment

Hong¹,

Chen²,

Zheng³

et al. 2017

TCRM

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ObjectiveThere is little evidence on the role of topical budesonide in reducing the frequency of adenoidectomy, although it was reported that topical budesonide can effectively ameliorate the symptoms of adenoid hypertrophy (AH). This study was aimed to investigate the possibility and safety of alternatives to adenoidectomy with a 12-week treatment with nasal budesonide.Materials and methodsOne hundred patients with AH were randomized to receive either a double-blind budesonide (1 mg once daily) or placebo treatment for 2 weeks by transnasal nebulization. A further 12-week open study, budesonide spray (64 μg per nostril at bedtime) was administered to the treatment group. During the final 12 weeks of follow-up, the frequency of adenotonsillectomy, side effects, the degree of nasal obstruction, nasal discharge, and snoring were assessed.ResultsOut of the 100 total enrolled patients, 92 children with AH completed the study. After the 2-week treatment with transnasal budesonide nebulization, the symptoms of AH significantly decreased compared to the control group. Responders (n=26) who had initially improved showed significantly decreased symptoms of AH, and the frequency of adenotonsillectomy during the follow-up (14 and 26 weeks) was compared with that of the control group and non-responders (n=21) who did not respond to the initial 2-week budesonide therapy. The 12-week nasal budesonide treatment did not suppress the growth rate of children’s height or cause other side effects.ConclusionAH children who had improved after an initial 2-week budesonide therapy can achieve clinical improvements and decreased frequency of adenoidectomy following the therapy with a 12-week treatment with nasal budesonide.

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Section: Discussionmentioning

confidence: 90%

Decreased frequency of adenoidectomy by a 12-week nasal budesonide treatment

Hong¹,

Chen²,

Zheng³

et al. 2017

TCRM

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“…In previous studies, intranasal corticosteroids have been shown to significantly improve symptoms in patients with moderate to severe adenoidal hypertrophy, as well as decrease adenoid size [64,65]. In a 2015 review and meta-analysis of eight randomized controlled trials using mometasone for adenoid hypertrophy, it was found to be associated with improved nasal obstruction and symptoms, decreased adenoid size, and improved quality of life [66]. Fluticasone (Flonase®) has also been shown to significantly improve airway obstruction, mouth breathing, apnea, night cough, and even speech abnormalities, compared to normal saline [67].…”

Section: Non-surgical Therapy For Adenoid Hypertrophymentioning

confidence: 99%

Adenoidectomy in Children: What Is the Evidence and What Is its Role?

Schüpper

Nation

Pransky

2018

Curr Otorhinolaryngol Rep

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Purpose of Review Review the current state of the adenoidectomy procedure in the pediatric population with up-to-date indications for surgery, operative techniques, adverse events, non-surgical management of adenoid hypertrophy, and future directions. Recent Findings Adenoidectomy is indicated in children for the treatment of sleep-disordered breathing, nasal airway obstruction, recurrent acute otitis media, and chronic rhinosinusitis. A new recommendation was released in 2016, not supporting adenoidectomy for a primary indication of otitis media in children under 4 years old, including those with prior tympanostomy tubes, unless a distinct indication exists such as nasal obstruction or chronic adenoiditis. Although adenotonsillectomy is the mainstay of treatment for obstructive sleep apnea (OSA), recent studies have identified that non-obese patients with moderate OSA and small tonsils have comparable benefits with adenoidectomy alone with less complications. While conventional approaches such as indirect mirror-assisted curette and suction coagulation are still utilized, direct transnasal endoscopeassisted removal of the adenoids has proven to be a safe technique, with good short-and long-term outcomes. Novel nonsurgical therapies including immunotherapy have been evaluated. Summary Adenoidectomy is a safe procedure in the pediatric population and leads to excellent outcomes. Adverse events are rare, and hospitalization is uncommon. Children with sleep disturbance from nasal airway obstruction, ear disease, or chronic rhinosinusitis are the best operative candidates for this procedure.

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“…Obstructive adenoid and allergic rhinitis may cause not only nasal obstruction but also mouth breathing mode and other consequences [2][3][4] . The postural compensation for airflow maintenance may target not only the lip and tongue posture, but also the whole body, mainly in morphologically prone patterns 3 .…”

Section: Introductionmentioning

confidence: 99%

Nasal patency and craniocervical posture in scholar children

et al. 2017

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One hundred thirty-three children were distributed into two groups: G1 (normal nasal patency -PNIF higher than 80% of predicted value) with 90 children; G2 (decreased nasal patency -PNIF lower than 80% of predicted value) with 43 children. Differences between groups were not found in CD and HHA measures. FE was significantly higher in G2 than G1 (p=0.023). Negative weak correlation between p=0.002) Palabras clave |

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Systematic review and meta-analysis of randomized controlled trials on the role of mometasone in adenoid hypertrophy in children

Cited by 68 publications

References 22 publications

Decreased frequency of adenoidectomy by a 12-week nasal budesonide treatment

Decreased frequency of adenoidectomy by a 12-week nasal budesonide treatment

Adenoidectomy in Children: What Is the Evidence and What Is its Role?

Nasal patency and craniocervical posture in scholar children

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