Abstract | OBJECTIVE: DATA SOURCES: Published studies indexed in the MEDLINE (1951 to 2008), EMBASE (1974 to 2008), and the Cochrane databases (Issue 3, 2008). REVIEW METHODS: Data from the included trials were extracted and trial quality was assessed. Meta-analysis was not applicable and data were summarized in a narrative format. Evidence from excluded studies was also discussed. RESULTS: Seven studies (six randomized controlled trials and one cohort study) met the inclusion criteria of the review, including a total of 493 patients. Six of these studies demonstrated significant efficacy of various nasal steroids ( mometasone, beclomethasone, flunisolide) in improving nasal obstruction symptoms and in reducing adenoid size, as measured with symptom scores and fiber-optic nasopharyngeal endoscopy, respectively. The response appeared to be a group effect and may be maintained longer-term by continuing nasal steroids at a lower maintenance dose. The treatment was safe and well-tolerated with few minor adverse events. CONCLUSION: The available evidence suggests that nasal steroids may significantly improve nasal obstruction symptoms in children with adenoid hypertrophy. This improvement appears to be associated with a reduction of adenoid size. Evidence of long-term efficacy is limited but suggests that in many children maintenance therapy is needed if symptom-relief is to persist. Further studies are required to support the use of nasal steroids as a first-line approach in these children.
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Authors | Neil K Chadha, Linjie Zhang, Raúl A Mendoza-Sassi, Juraci A César |
Journal | Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
(Otolaryngol Head Neck Surg)
Vol. 140
Issue 2
Pg. 139-47
(Feb 2009)
ISSN: 0194-5998 [Print] England |
PMID | 19201278
(Publication Type: Journal Article, Review)
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Chemical References |
- Anti-Inflammatory Agents
- Glucocorticoids
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Topics |
- Adenoids
(pathology)
- Administration, Intranasal
- Anti-Inflammatory Agents
(administration & dosage)
- Child
- Glucocorticoids
(administration & dosage)
- Humans
- Hypertrophy
(complications)
- Nasal Obstruction
(drug therapy, etiology, pathology)
- Treatment Outcome
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