Journal Article

Maximal medical treatment of adenoid hypertrophy: a prospective study of preschool children

Zwierz, Aleksander, Domagalski, Krzysztof, Burduk, Paweł, Masna, Krystyna

2024

Overview

Purpose This study aimed to examine the effectiveness of the combined maximal medical treatment for adenoid hypertrophy in preschool children. Methods Sixty-four children underwent one-year combined therapy with intranasal mometasone furoate, oral desloratadine, nasal saline irrigation, and bacteriotherapy. Additionally, decongestion drops were applied during scheduled breaks. Results Of the 64 treated children, 72% showed clinical improvement in adenoid symptoms while 28% did not improve and underwent surgery. These groups differed significantly in terms of the overall reduction in ailments after treatment ( p  < 0.001), infection rate ( p  < 0.001), catarrh severity ( p  < 0.001) and nasal patency ( p  < 0.001). Endoscopic examination confirmed that responders experienced, on average, a decrease of 8.4% in the adenoid/choana ratio and an improvement in mucosal coverage of the adenoid. These effects were not observed in the group of children whose parents opted for surgery after nine months of conservative treatment. Conclusions The proposed new schema of long-term maximal medical treatment with the use of combined intermittent treatment of intranasal mometasone furoate and decongestion drops, oral desloratadine, nasal saline irrigation, and bacteriotherapy can be attempted in patients with adenoid hypertrophy symptoms, and responders may avoid the need for surgery. The applied treatment breaks resulted in a low number of therapeutic side effects.

• Publisher: Springer Berlin Heidelberg,Springer Nature B.V
• Subject: Adenoidectomy / Adenoids / Child, Preschool / Head and Neck Surgery / Humans / Hypertrophy - drug therapy / Loratadine - analogs & derivatives / Medicine / Medicine & Public Health / Mometasone Furoate - therapeutic use / Neurosurgery / Otorhinolaryngology / Prospective Studies / Rhinology