Efficacy of Mometasone Nasal Spray in Children with Snoring due to Adenoids

ABSTRACT Background Snoring and OSA is very commonly seen among the pediatric population, most commonly due to adenoid and tonsil hypertrophy which requires adenotonsillectomy. The effect of this surgery on the immunity is controversial. This study was planned to see any alternative therapy which can delay or avoid the surgery by providing symptomatic relief to the patient. Objective To see the effect of intranasal mometasone on nasal obstruction due to adenoids, hence relieving the OSA and snoring. Design Prospective and observational study. Materials and methods Fifty-five children having snoring and or OSA due to adenoids were given intranasal mometasone. The symptoms before and after treatment were compared using OSA 18 questionnaire. Results There was significant improvement in all the domains of OSA 18. The average total score showed improvement from 56.33 to 51.51 which is significant (p < 0.001). Conclusion The use of intranasal steroids is easy and effective method to improve nasal obstruction, snoring and OSA among children having adenoid hypertrophy. How to cite this article Gupta V, Gupta M, Matreja PS, Singh S. Efficacy of Mometasone Nasal Spray in Children with Snoring due to Adenoids. Clin Rhinol An Int J 2014;7(1):1-4.

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Role of mometasone furoate nasal spray in children with adenoid hypertrophy: impact on life style changes

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20203578 ◽

2020 ◽

Vol 6 (9) ◽

pp. 1709

Author(s):

Venkatesha B. K. ◽

Ravi Shekhar

Keyword(s):

Nasal Obstruction ◽

Nasal Spray ◽

Statistical Tests ◽

Nasal Congestion ◽

Sleep Apnea Syndrome ◽

Mometasone Furoate ◽

Nasal Discharge ◽

Adenoid Hypertrophy ◽

Obstructive Sleep ◽

Life Style Changes

Background: Adenoid hypertrophy (AH) is a common cause of upper airway obstruction and obstructive sleep apnea syndrome (OSAS) in children having major impact on child’s growth and development. Symptoms like nasal congestion, mouth breathing, nasal discharge, snoring, day time sleepiness, hyponasal voice, ear popping, and craniofacial abnormalities are observed. Adenoidectomy is considered the treatment of choice for symptomatic children. Co-existing medical illnesses and choice of surgical treatment is governed by the paediatricians and apprehensive parents. Need for conservative treatments in alleviating symptoms have been tried. Topical, intranasal administered, steroid preparations have been proven effective in the literature.Methods: In this prospective study, 35 symptomatic children (3-12 years) with adenoid hypertrophy were included. Each of the symptoms was scored from 0 (absent) to 4 (severe) over Visual Analogue Scale (VAS). Nasal obstruction index was calculated. Results of mometasone furoate nasal spray 100 microgram/day used once daily at the interval of 8 weeks and 12 weeks were analysed using statistical tests. Results: A statistically significant reduction in nasal obstruction index and other symptoms were noted at the end of third month follow up.Conclusions: Mometasone furoate nasal spray caused improvements in outcomes of nasal obstruction, snoring, total nasal symptoms, ear symptoms and overall quality of life.

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The treatment of hyposmia with intranasal steroids

The Journal of Laryngology & Otology ◽

10.1017/s0022215100132967 ◽

1996 ◽

Vol 110 (2) ◽

pp. 132-135 ◽

Cited By ~ 40

Author(s):

David G. Golding-Wood ◽

Mats Holmstrom ◽

Yvonne Darby ◽

Glenis K. Scadding ◽

Valerie J. Lund

Keyword(s):

Nasal Obstruction ◽

University Of Pennsylvania ◽

Clear Correlation ◽

Nasal Discharge ◽

Initial Symptoms ◽

Intranasal Steroids ◽

Before And After ◽

Perennial Rhinitis ◽

Vas Scores ◽

Analogue Scales

AbstractHyposmia is a neglected symptom in patients with rhinitis. We studied 25 patients presenting with perennial rhinitis. Fifteen patients expressed hyposmia as a significant symptom. University of Pennsylvania smell identification test (UPSIT) and visual analogue scales (VAS) were used to score the symptoms of hyposmia, nasal obstruction and nasal discharge before and after six weeks treatment with betamethasone sodium phosphate drops. Those patients with initial symptoms of hyposia significantly improved their UPSIT scores (p= 0.00009) and their VAS scores for hyposmia (p= 0.00133). Despite a significant decrease in the sensation of nasal obstruction, the non-hyposmics showed no increase in UPSIT scores after betamethasone therapy. There was no clear correlation between UPSIT results and other symptom scores. The judicious use of betamethasone drops in the treatment of rhinogenic hyposmia can be recommended.

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Adenoidectomy versus mometasone furoate nasal spray in treatment of nasal obstruction in children due to adenoid hypertrophy: a comparative study

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20190007 ◽

2019 ◽

Vol 5 (2) ◽

pp. 310 ◽

Cited By ~ 1

Author(s):

Vishwas K. Pai ◽

Shravan S. Shetty ◽

P. P. Devan ◽

S. G. Mahesh

Keyword(s):

Nasal Obstruction ◽

Nasal Spray ◽

Surgical Removal ◽

Adenoid Hypertrophy ◽

Significant Difference ◽

Group A ◽

Pre Treatment ◽

Group B

Background: One of the common causes for nasal obstruction in children is adenoid hypertrophy. It is common indication for surgical removal in these patients due to multiple morbidities. In severe symptoms adenoidectomy is recommended, however there are limitations for surgery like cleft palate.The safety of nasal steroid spray has been well reported. The aim of the current study is to determine the effectiveness of adenoidectomy verses mometasone nasal spray in treatment of children with adenoid hypertrophy.Methods: Randomized prospective study was conducted in the department of ENT on 60 children who met the inclusion criteria. They were randomized into 2 groups and pre-treatment scoring was accessed. Group A underwent adenoidectomy and Group B underwent mometasonefuroate nasal spray therapy. Patients were evaluated on 40th day, 4th month. Results: During the 40th day follow up post treatment, a significant difference was found with no nasal obstruction in 93.3% patients who underwent adenoidectomy compared to 63.3% for those treated with MF nasal. At follow up after 4 months, 93.3% patients in group A had had improvement in clinically as compared to 76.6% in group B were nasal obstruction was relived. In group A, there was significant reduction in adenoid grading after adenoidectomy compared to MF nasal spray at 40 days follow up (p≤0.001). However long term MF nasal spray also associated with significant reduction in the size.Conclusions: In patients were adenoidectomy is contraindicated, long term MF nasal spray treatment has good efficacy in treatment of nasal obstruction due to adenoid hypertrophy.

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Role of mometasone furoate nasal spray versus saline nasal spray in treatment of adenoid hypertrophy: a prospective, randomized study

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20204186 ◽

2020 ◽

Vol 6 (10) ◽

pp. 1841

Author(s):

Rabia Monga ◽

Sanjeev Bhagat ◽

Vishal Sharma ◽

Dimple Sahni ◽

Harjinder Singh ◽

...

Keyword(s):

Nasal Obstruction ◽

Nasal Spray ◽

Clinical Symptoms ◽

Randomized Study ◽

Mometasone Furoate ◽

Nasal Endoscopy ◽

Prospective Randomized Study ◽

Common Symptom ◽

Adenoid Hypertrophy ◽

Obstructive Sleep

Background: Adenoid hypertrophy is a common disorder in the paediatric population, presenting with multiple signs and symptoms ranging from nasal obstruction to obstructive sleep apnoea. Most common symptom is usually nasal airway obstruction. This prospective, randomized study aims to evaluate the efficacy of mometasone furoate spray in reducing size and clinical symptoms in patients with adenoid hypertrophy compared to saline spray.Methods: 60 patients in the age group of 3-11 years were enrolled in the study. Five symptoms were included that were hypo nasal speech, snoring, night cough, open mouth breathing and nasal obstruction which were scored as never=0, mild (sometimes)=1, moderate (less than 50% of times)=2, and severe (constant)=3. Diagnosis of adenoid hypertrophy was made on basis of nasal endoscopy.Results: Significant improvement was seen in individual as well as overall symptom score in group A as compared to group B after 8 weeks of treatment (p<0.001). There was significant improvement in mean adenoid grade as per nasal endoscopy at 8 weeks post therapy (p<0.001) which was not seen after 4 weeks of therapy.Conclusion: Intranasal steroid sprays have good role in decreasing the symptoms of adenoid hypertrophy and has reduced number of adenoidectomies required. The long-term effects as well as optimal duration of therapy is still controversial and needs to be studied further.

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Adenoidectomy: Conventional or Endoscopic Assisted?

Clinical Rhinology An International Journal ◽

10.5005/jp-journals-10013-1312 ◽

2017 ◽

Vol 10 (2) ◽

pp. 74-77

Author(s):

Anuj K Goel

Keyword(s):

Nasal Obstruction ◽

Pediatric Population ◽

Complete Removal ◽

Adenoid Hypertrophy ◽

Success Rates ◽

Radiological Investigation ◽

Suppurative Otitis Media ◽

Adenoid Tissue ◽

Number Of Patients ◽

Chronic Adenoiditis

ABSTRACT Objectives Adenoid hypertrophy is known as the most common cause of nasal obstruction in children; thus, adenoidectomy is one of the most commonly performed surgical procedures in the pediatric population. We performed both conventional and endoscopic-assisted adenoidectomies in 54 patients. Our objectives were to compare the efficacy of both methods in terms of subjective and objective relief of symptoms, safety, recurrence, and postoperative morbidity. Materials and methods Fifty-four patients were studied and were diagnosed depending upon clinical examination and radiological investigation. The patients were operated by either conventional or endoscopic-assisted adenoidectomy (EAA). Intraoperative and postoperative complications were looked for. After discharge from the hospital, the patients were called for follow-up on 1st week, 3rd week, 2nd and 4th month, and patients were asked for relief of symptoms and examined for nasal disease and for recurrence. Results Adenoid hypertrophy was seen commonly in children and the most common presenting complaints were nasal obstruction, mouth breathing, and snoring. The patients were diagnosed to have chronic adenoiditis, chronic adenotonsillitis, with or without chronic suppurative otitis media. More number of patients became symptom free with EAA as compared with conventional adenoidectomy. Conclusion Conventional adenoidectomy and EAA both have comparable success rates. Endoscopic-assisted adenoidectomy allows complete removal of adenoid tissue, thereby reducing the chances of developing recurrent adenoid obstructive symptoms and reducing the bacterial reservoir in the nasopharynx. How to cite this article Goel AK. Adenoidectomy: Conventional or Endoscopic Assisted? Clin Rhinol An Int J 2017;10(2):74-77.

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Observational study investigating Ectoin® Rhinitis Nasal Spray as natural treatment option of acute rhinosinusitis compared to treatment with Xylometazoline

European Archives of Oto-Rhino-Laryngology ◽

10.1007/s00405-021-06916-0 ◽

2021 ◽

Author(s):

Nina Werkhäuser ◽

Andreas Bilstein ◽

Kathrin Mahlstedt ◽

Uwe Sonnemann

Keyword(s):

Side Effects ◽

Observational Study ◽

Nasal Spray ◽

Nasal Mucosa ◽

Treatment Option ◽

Symptomatic Relief ◽

Concomitant Treatment ◽

Acute Rhinosinusitis ◽

Nasal Decongestants ◽

Natural Treatment

Abstract Introduction Symptomatic relief of acute rhinosinusitis is commonly achieved with nasal decongestants. The current observational study investigated the efficacy and safety of treatment of acute rhinosinusitis with Ectoin® Rhinitis Spray compared to or in combination with Xylometazoline-containing decongesting nasal spray. Methods Patients with acute rhinosinusitis applied either Ectoin® Rhinitis Spray, Xylometazoline nasal spray or a combination of both products. Rhinosinusitis symptoms were assessed, and nasal oedema and endonasal redness were determined by rhinoscopy. Patient diaries based on the validated SNOT (Sino Nasal Outcome Test) questionnaire evaluated rhinosinusitis parameters over time and influences of the disease on quality of life. Following treatment, investigators and patients judged the efficacy and tolerability. Results Ectoin® Rhinitis Spray diminished common rhinosinusitis symptoms such as nasal obstruction, nasal secretion, facial pain/headache, and smell/taste impairment. Upon treatment over 7 days, rhinosinusitis sum scores decreased statistically significantly (p < 0.001) by − 64.25%, which was comparable to that achieved with Xylometazoline-containing decongesting nasal spray (− 67.60%). No side effects were observed during treatment with Ectoin® Rhinitis Spray, whereas treatment with Xylometazoline-containing nasal spray resulted in nasal mucosa dryness. Concomitant treatment with both products diminished the development of nasal dryness and required fewer applications of Xylometazoline-containing nasal spray. Conclusion Ectoin® Rhinitis Spray is an effective, natural treatment option for acute rhinosinusitis, which may be used as monotherapy or as add-on treatment with a Xylometazoline-containing nasal spray. The concomitant use of Ectoin® Rhinitis Spray might reduce the needed dose of decongestant nasal spray and counteract bothersome side effects such as dry nasal mucosa. Trial registration The current study was registered in the ClinicalTrials.gov database under the identifier: NCT03693976 (date of registration: Oct 3, 2018).

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The impact of fluorescein-guided technique in the surgical removal of CNS tumors in a pediatric population: results from a multicentric observational study

Journal of Neurosurgical Sciences ◽

10.23736/s0390-5616.19.04601-0 ◽

2020 ◽

Vol 63 (6) ◽

Author(s):

Camilla de Laurentis ◽

Julius Höhne ◽

Claudio Cavallo ◽

Francesco Restelli ◽

Jacopo Falco ◽

...

Keyword(s):

Observational Study ◽

Pediatric Population ◽

Cns Tumors ◽

Surgical Removal ◽

The Impact

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Suicide ideation, anger and impulsiveness in chronic pain patients before and after pain relief: an observational study

10.26226/morressier.5971be84d462b80290b53122 ◽

2017 ◽

Author(s):

Valerio Mancini

Keyword(s):

Chronic Pain ◽

Pain Relief ◽

Observational Study ◽

Suicide Ideation ◽

Chronic Pain Patients ◽

Before And After ◽

Pain Patients

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Eustachian Tube Dysfunction in Children With Adenoid Hypertrophy: The Role of Adenoidectomy for Improving Ear Ventilation

Ear Nose & Throat Journal ◽

10.1177/0145561321989455 ◽

2021 ◽

pp. 014556132198945

Author(s):

Alessandra Manno ◽

Giannicola Iannella ◽

Vincenzo Savastano ◽

Tommaso Vittori ◽

Serena Bertin ◽

...

Keyword(s):

Eustachian Tube ◽

Otitis Media With Effusion ◽

Preoperative Evaluation ◽

Mean Value ◽

Eustachian Tube Dysfunction ◽

Adenoid Hypertrophy ◽

Before And After ◽

Middle Ear Ventilation ◽

Tube Dysfunction ◽

The Impact

Introduction: To our knowledge, few papers have addressed preoperative evaluation of the impact of adenoid hypertrophy (AH) on the pathogenesis of eustachian tube dysfunction (ETD) in children with otitis media with effusion (OME). Aim: The aim of this study was 2-fold: first, to evaluate ETD using tubomanometry and Eustachian Tube Score 7 (ETS-7), in a group of children having AH; second, to assess the clinical impact of adenoidectomy on the ETD of these patients. Methods: Fifty patients, aged 4 to 15 years, underwent adenoidectomy based on various parameters: size of the adenoids causing canal obstruction (grades 1-4), the presence of OME, and recurrent episodes of rhinosinusitis. The function of the eustachian tube was evaluated using ETS-7 before and after surgical treatment. The patients were followed up for 6 months. Results: Forty children presented ETD. Of these, 36 had a grade 4 AH. The preoperative mean value for ETS-7 was 6.62. The mean postoperative ETS-7 score showed a value of 9.60 with a statistical difference compared to the preoperative value ( P = .0015). Conclusions: Adenoid hypertrophy has a high impact on the frequency of ETD. In the patients observed in the present study, the ETS-7 score appeared to be a valid tool for assessing ETD both preoperatively and postoperatively. Adenoidectomy seemed to be effective in improving ETD as well as middle ear ventilation.

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Surgery to relieve nasal obstruction: outcome for 366 patients operated on by one senior surgeon

European Archives of Oto-Rhino-Laryngology ◽

10.1007/s00405-021-06696-7 ◽

2021 ◽

Author(s):

Lars Aksel Pedersen ◽

S. Dölvik ◽

K. Holmberg ◽

C. Ahlström Emanuelsson ◽

H. Johansson ◽

...

Keyword(s):

Beneficial Effect ◽

Nasal Obstruction ◽

General Health ◽

Surgical Skills ◽

Nasal Endoscopy ◽

Experienced Surgeon ◽

Senior Surgeon ◽

Significant Difference ◽

Before And After ◽

The Mean

Abstract Background Studies of patient-rated outcome in septoplasty and turbinoplasty most frequently involve several surgeons with varying surgical skills, techniques and experience. The aim of the present study was to evaluate outcome based on one experienced surgeon. Methods Three hundred and sixty-six consecutive patients referred for nasal obstruction were included. All the patients were examined with nasal endoscopy before and after decongestion, they filled out a nose VAS and rated their overall general health before and three to six months after surgery. The patients underwent septoplasty, septoplasty plus turbinoplasty or turbinoplasty. Results The mean nose VAS for nasal obstruction (0–100) preoperatively was 64.7 for all patients. Patients undergoing septoplasty (n = 159) were younger than patients undergoing septoplasty + turbinoplasty (n = 79) or patients undergoing turbinoplasty alone (n = 128). The nose VAS for nasal obstruction improved significantly in all three groups and 25% had a normal nose VAS after surgery in the septoplasty and septoplasty + turbinoplasty groups compared to only 8% in the turbinoplasty alone group. There was no significant difference in the improvement in nasal obstruction between septoplasty and septoplasty + turbinoplasty, but the septoplasty + turbinoplasty group experienced a significantly greater improvement in general health. Conclusions In 366 patients operated on by one experienced surgeon, septoplasty and septoplasty + turbinoplasty were more effective at relieving nasal obstruction than turbinoplasty alone. Septoplasty + turbinoplasty resulted in a greater improvement in general health than septoplasty alone, despite the same improvement in nasal obstruction, indicating a beneficial effect of additional turbinoplasty in septoplasty.

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