Objective reduction in adenoid tissue after mometasone furoate treatment

• Published in: International journal of pediatric otorhinolaryngology 2012-06, Vol.76 (6), p.829-831
• Main Authors: Rezende, Renato M, Silveira, Flávia, Barbosa, Aline P, Menezes, Ulissis P, Ferriani, Virgínia P.L, Rezende, Patrícia H.C, Anselmo-Lima, Wilma T, Valera, Fabiana C.P
• Format: Article
• Language: English
• Subjects: Adenoid hypertrophy; Adenoid tissue; Adenoids - drug effects; Adenoids - pathology; Administration, Intranasal; Anti-Inflammatory Agents - therapeutic use; Child; Child, Preschool; Chronic Disease; Cohort Studies; Environment; Female; Follow-Up Studies; Glucocorticoid; Humans; Hypertrophy - complications; Hypertrophy - drug therapy; Male; Mometasone Furoate; Nasal obstruction; Nasal Obstruction - drug therapy; Nasal Obstruction - etiology; Observer Variation; Otolaryngology; Pediatrics; Pregnadienediols - therapeutic use; Rhinitis - complications; Rhinitis - diagnosis; Rhinitis - drug therapy; Risk Assessment; Snoring; Sodium Chloride - therapeutic use; Statistics, Nonparametric; Therapeutic Irrigation - methods; Treatment Outcome
• ISSN: 0165-5876; 1872-8464
• DOI: 10.1016/j.ijporl.2012.02.052

Abstract Objective Chronic rhinitis and adenoid hypertrophy are the main causes of nasal obstruction in children and proper treatment of these factors seem essential for controlling nasal obstructive symptoms. This study aims to evaluate the effects of topical mometasone treatment on symptoms and size of adenoid tissue in children with complaints of nasal obstruction and to compare this approach to continuous nasal saline douching plus environmental control alone. Methods Fifty-one children with nasal obstructive complaints were submitted to a semi-structured clinical questionnaire on nasal symptoms, prick test and nasoendoscopy. Nasoendoscopic images were digitalized, and both adenoid and nasopharyngeal areas were measured in pixels. The relation adenoid/nasopharyngeal area was calculated. Patients were subsequently re-evaluated in two different periods: following 40 days of treatment with nasal douching and environmental prophylaxis alone; and after an subsequent 40 day-period, when topical mometasone furoate (total dose: 100 μg/day) was superposed. Results Nasal symptoms and snoring significantly improved after nasal douching, and an additional gain was observed when mometasone furoate was included to treatment. Saline douching did not influence the adenoid area, whereas a significant reduction on adenoid tonsil was observed after 40 days of mometasone treatment ( P < 0.0001). Conclusion Nasal saline douching significantly improved nasal symptoms without interfering in adenoid dimension. In contrast, mometasone furoate significantly reduced adenoid tissue, and led to a supplementary improvement of nasal symptoms.