The Role of Intranasal Corticosteroid Therapy on Pediatric Adenoidal Hypertrophy: A Randomized Clinical Trial Study

Adenoidal hypertrophy (AH) is a common disorder in pediatric population with severe complications due to nasal air way obstruction. Adenoidectomy is a choice treatment for children with severe symptoms due to AH, however; it is accompanied with several side effects such as complication of surgery and emotional distress. We evaluated the efficacy of intranasal corticosteroid (Fluticasone) therapy on size and symptoms of Adenoid Hypertrophy.

In this clinical trial 45children with AH (2-14 years old) were enrolled. All of them underwent 8 weeks course of intranasal Fluticasone therapy and their symptoms before and after treatment were scored and also compared by questionnaires. They were divided into Atopic and non- Atopic groups and these two groups were compared with each other after treatment according to their response to therapy.

After 8 weeks treatment with intra nasal fluticasone, improvement in all symptoms score of AH including (Snoring , Sleep Apnea ,Mouth breathing and Nasal congestion)  was statistically significant(p=0.000). Significant improvement after treatment was observed in atopic patients and 92% of them (36 of 39) showed decrease clinical symptom of AH however this number in non-atopic patients was 50% (p value =0.024).

Our study demonstrates that an 8 weeks treatment with intranasal corticosteroid (Fluticasone) is associated with decrease in size of AH and all symptoms of obstruction. So intranasal corticosteroid therapy can prevent of adenoidectomy especially in atopic patients.