IntroductionAdenoids are pyramid-shaped enlarged masses of lymphoid tissue in the nasopharynx (1), and they form an important part of Waldeyer's tonsillar ring. Although the adenoids are very small at birth, they may exhibit growth in the first 4 years of life, depending on the development of the immune system (2).The incidence of adenoid hypertrophy is 2%-3% in children (2). Untreated adenoid hypertrophy may lead to difficulty in breathing through the nose, snoring, sleep apnea, nasal speech, ear problems, growth retardation, and craniofacial anomalies (1,2). Various methods are used for the diagnosis of adenoid hypertrophy including lateral head radiography, videofluoroscopy, palpation, and nasal endoscopy; the most recent methods are lateral radiographs and nasal endoscopy (3).Adenoidectomy is a commonly performed procedure in children that may cause complications such as early or late bleeding (4%-5%), adenoid tissue recurrence (10%-20%), and postoperative respiratory problems (27%) (2). In addition, anesthesia risks are also among the factors that should be taken into account (4). As such, medical therapy alternatives to adenoidectomy are important and must be tried before surgery.Leukotrienes are inflammatory mediators found in the respiratory system and these play a role in several allergic childhood diseases (5). Cysteinyl leukotriene receptor-1 mediates the inflammatory pathway and has been found in high rates in postoperative adenotonsillar tissues in pediatric patients with obstructive sleep apnea (6-8). Montelukast is an effective and reliable cysteinyl leukotriene receptor antagonist that can be used in oral form and has high bioavailability. It was approved by the United States Food and Drug Administration (FDA) for preventive therapy against the inflammatory component in asthma and allergic rhinitis in children aged over 1 year. Background/aim: The incidence of adenoid hypertrophy is 2%-3% in children. Adenoidectomy is a commonly performed procedure in children that may cause complications such as early or late bleeding (4%-5%), recurrence of adenoid tissue (10%-20%), and postoperative respiratory problems (27%). Therefore, medical therapy alternatives to adenoidectomy are important and must be tried before surgery. In this study, we investigated the efficacy of mometasone furoate, montelukast, and a combination of these drugs in pediatric patients with adenoid hypertrophy who were scheduled for reduction with medical therapy after not being recommended for surgery.
Materials and methods:The study included 120 children with adenoid hypertrophy aged between 4 and 10 years. The patients were randomized into 4 separate groups, with 30 in each group. Group 1 received 100 µg of mometasone furoate per day, group 2 received 4/5 mg (for age) montelukast per day, and group 3 received mometasone furoate + montelukast. Medical therapy continued for 3 months in the treatment groups. Group 4, which comprised patients with mild symptoms, received no treatment and was the control group. The pre-and posttreatment ...
