Topical nasal steroids for adenoid hypertrophy in children: A systematic review and meta-analysis.

OBJECTIVE

Adenoid hypertrophy (AH) is a common pathology in children leading to nasal obstruction, sleep disordered breathing, and obstructive sleep apnea. Symptomatic AH is often treated surgically, and several medical interventions have been investigated with varying results. The objective of this study is to provide a comprehensive meta-analysis of the use of intranasal corticosteroids (INCS) for AH.

DATA SOURCES: Cochrane, SCOPUS, PubMed, CINAHL.

REVIEW

METHODS

This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies of interest included those evaluating INCS for adenoid hypertrophy in children with the presence of a control group.

RESULTS

A total of 16 studies comprising 1156 patients were included. INCS were evaluated in 636 patients, and 520 patients served as controls. The percentage of patients with severe AH in the INCS group saw a significantly greater decrease after treatment compared to the control group (-43.5 vs -13.3, [95 % CI: 19.8-39.7 %], p < 0.0001). The INCS group also experienced greater decreases in nasal obstruction (-1.6 vs -0.6) and nasal itching (-0.7 vs -0.2) compared to the control group (both p < 0.05). The rate of adenoidectomy following medical treatment was 22.3 % in the treatment group, compared to 98.6 % in the control group (76.2 % [95 % CI: 57.0-86.6 %] p < 0.0001).

CONCLUSION

INCS demonstrate efficacy in treating adenoid hypertrophy and its related sequelae in children. Improvements were noted in both subjective symptom severity and physiologic measurements of AH, indicating that INCS may reduce the need for surgery in selected patients.