LONG TERM USE OF MOMETASONE FUROATE AQUEOUS NASAL SPRAY VERSUS ADENOIDECTOMY IN THE MANAGEMENT OF ADENOID HYPERTROPHY IN CHILDRENS- A COMPARITIVE STUDY

Abstract

Background: One of the common causes for nasal obstruction in children is adenoid hypertrophy which is a common indication for surgical removal due to associated diseases. Long term use of steroid spray also
Objectives: The aim of the current study was to compare invasive and noninvasive treatment modalities in the treatment adenoid hypertrophy in the children between 5-15 year ages.
Methods: a comparative prospective study conducted on 5-15 year old children with pre diagnosed adenoid hypertrophy. 30 patients each group was treated either by long term mometasone furoate (MF) nasal spray i.e. Group A and Adenoidectomy i.e. Group B. MF nasal spray was prescribed to the patients for 3 hourly everyday for 3 months. Adenoidectomy was performed under general anesthesia. Symptoms like Adenoid hypertrophy grading, nasal obstruction, snoring and interruption in mouth breathing were evaluated Pre and post treatment. Nasal obstruction was counted as mild, moderate and severe. Presence of snoring and interruption in mouth breathing were observed. The follow up was taken on 15th day, at the end of 1st month and 3rd month.
Results: Few common symptoms of adenoid hypertrophy were observed prior and after the treatment. Follow up period was evaluated on 15th day, 1 month and 3 month. Out of 60 patients, only 3 (10%) patients showed nasal obstruction by 3rd month, 6 (20%) patients had increase in adenoid size, 5 (16.66%) patients showed snoring and 3 (10%) patients showed interrupted mouth breathing. Out of 30 patients in Group B; only 2 (6.66%) patients showed nasal obstruction and snoring. There was no growth in adenoid size and obstruction in mouth breathing. All the findings were statistically significant. Interrupted mouth breathing was found to be more relieved symptom.
Conclusion: adenoidectomy and long term MF nasal spray treatment both has good efficacy in treatment of nasal obstruction due to adenoid hypertrophy. Long term non invasive local steroid therapy was used where surgery was contraindicated. Adenoidectomy was found to be more reliable as recurrence rate was minimal.
Keywords: adenoid hypertrophy, adenoidectomy, nasal obstruction, mometasone furoate (MF) nasal spray.