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The role of topical nasal steroids in the treatment of children with otitis media with effusion and/or adenoid hypertrophy.
Int J Pediatr Otorhinolaryngol. 2006 Apr; 70(4):639-45.IJ

Abstract

OBJECTIVES

Topical steroid treatment can be a powerful alternative to surgery in controlling adenoid hypertrophy and otitis media with effusion (OME).

METHODS

A prospective, controlled, randomized, clinical study in an academic tertiary care center. A total of 122 children (3-15-year-old) on the waiting list for an adenoidectomy and/or ventilation tube placement were enrolled into the study and control groups. The study group (67 patients with adenoid hypertrophy, 34 of them with otitis media with effusion) received intranasal mometasone furoate monohydrate 100 mcg/day, and the control group (55 patients with adenoid hypertrophy, 29 of them with otitis media with effusion) was followed up without any treatment. All patients were evaluated at 0 and 6 weeks. The assessment of each patient included history, a symptom questionnaire, a skin prick test, a tympanogram, if possible a pure tone audiogram, and otoscopic and endoscopic examinations. The size of adenoid tissue was graded as a percentage according to obliteration of the choanae. The adenoid/choana ratio (A/C) was recorded for each patient. Symptoms were scored as 0 (absent), 1 (intermittent/periodic), or 2 (continuous). The data were analyzed with the "Statistical Package for the Social Sciences" (SPSS 9.0) using the appropriate nonparametric tests for nominal and ordinal data.

RESULTS

Resolution of otitis media with effusion in the study group (42.2%) was significantly higher than that in the control group (14.5%) (p<0.001). Forty-five patients (67.2%) with adenoid hypertrophy in the study group showed a significant decrease in adenoid size according to the endoscopic evaluation compared to the control group (p<0.001). A significant improvement in obstructive symptoms was seen in the study group (p<0.001). The endoscopically measured adenoid/choana ratio and degree of obstructive symptoms showed a significant correlation (r=0.838 p<0.001, r=0.879 p<0.001, r=0.838 p<0.001, r=0.879 p<0.001). The adenoid/choana ratio improved significantly in atopic patients in the study group (p<0.05), whereas in atopic patients in the control group there was no change (p=0.221).

CONCLUSION

Nasal mometasone furoate monohydrate treatment can significantly reduce adenoid hypertrophy and eliminate obstructive symptoms. It is a useful alternative to surgery, at least in the short term, for otitis media with effusion.

Authors+Show Affiliations

Hacettepe University, Faculty of Medicine, Otorhinolaryngology Head-Neck Surgery, 06100 Ankara, Turkey. senemcengel@hotmail.comNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

16169093

Citation

Cengel, S, and M U. Akyol. "The Role of Topical Nasal Steroids in the Treatment of Children With Otitis Media With Effusion And/or Adenoid Hypertrophy." International Journal of Pediatric Otorhinolaryngology, vol. 70, no. 4, 2006, pp. 639-45.
Cengel S, Akyol MU. The role of topical nasal steroids in the treatment of children with otitis media with effusion and/or adenoid hypertrophy. Int J Pediatr Otorhinolaryngol. 2006;70(4):639-45.
Cengel, S., & Akyol, M. U. (2006). The role of topical nasal steroids in the treatment of children with otitis media with effusion and/or adenoid hypertrophy. International Journal of Pediatric Otorhinolaryngology, 70(4), 639-45.
Cengel S, Akyol MU. The Role of Topical Nasal Steroids in the Treatment of Children With Otitis Media With Effusion And/or Adenoid Hypertrophy. Int J Pediatr Otorhinolaryngol. 2006;70(4):639-45. PubMed PMID: 16169093.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The role of topical nasal steroids in the treatment of children with otitis media with effusion and/or adenoid hypertrophy. AU - Cengel,S, AU - Akyol,M U, Y1 - 2005/09/16/ PY - 2005/06/30/received PY - 2005/08/12/accepted PY - 2005/9/20/pubmed PY - 2006/9/23/medline PY - 2005/9/20/entrez SP - 639 EP - 45 JF - International journal of pediatric otorhinolaryngology JO - Int J Pediatr Otorhinolaryngol VL - 70 IS - 4 N2 - OBJECTIVES: Topical steroid treatment can be a powerful alternative to surgery in controlling adenoid hypertrophy and otitis media with effusion (OME). METHODS: A prospective, controlled, randomized, clinical study in an academic tertiary care center. A total of 122 children (3-15-year-old) on the waiting list for an adenoidectomy and/or ventilation tube placement were enrolled into the study and control groups. The study group (67 patients with adenoid hypertrophy, 34 of them with otitis media with effusion) received intranasal mometasone furoate monohydrate 100 mcg/day, and the control group (55 patients with adenoid hypertrophy, 29 of them with otitis media with effusion) was followed up without any treatment. All patients were evaluated at 0 and 6 weeks. The assessment of each patient included history, a symptom questionnaire, a skin prick test, a tympanogram, if possible a pure tone audiogram, and otoscopic and endoscopic examinations. The size of adenoid tissue was graded as a percentage according to obliteration of the choanae. The adenoid/choana ratio (A/C) was recorded for each patient. Symptoms were scored as 0 (absent), 1 (intermittent/periodic), or 2 (continuous). The data were analyzed with the "Statistical Package for the Social Sciences" (SPSS 9.0) using the appropriate nonparametric tests for nominal and ordinal data. RESULTS: Resolution of otitis media with effusion in the study group (42.2%) was significantly higher than that in the control group (14.5%) (p<0.001). Forty-five patients (67.2%) with adenoid hypertrophy in the study group showed a significant decrease in adenoid size according to the endoscopic evaluation compared to the control group (p<0.001). A significant improvement in obstructive symptoms was seen in the study group (p<0.001). The endoscopically measured adenoid/choana ratio and degree of obstructive symptoms showed a significant correlation (r=0.838 p<0.001, r=0.879 p<0.001, r=0.838 p<0.001, r=0.879 p<0.001). The adenoid/choana ratio improved significantly in atopic patients in the study group (p<0.05), whereas in atopic patients in the control group there was no change (p=0.221). CONCLUSION: Nasal mometasone furoate monohydrate treatment can significantly reduce adenoid hypertrophy and eliminate obstructive symptoms. It is a useful alternative to surgery, at least in the short term, for otitis media with effusion. SN - 0165-5876 UR - https://www.unboundmedicine.com/medline/citation/16169093/The_role_of_topical_nasal_steroids_in_the_treatment_of_children_with_otitis_media_with_effusion_and/or_adenoid_hypertrophy_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0165-5876(05)00397-6 DB - PRIME DP - Unbound Medicine ER -