Hypertonic Saline Solution in Children with Adenoidal Hyperytrophy: Preliminary Evidence

Abstract

Adenoidal hypertrophy (AH) is a frequent problem in children. A preliminary study evidenced that intranasal hypertonic solutions may exert an anti-inflammatory activity. The aim of the study is to evaluate the effect of intranasal hypertonic or isotonic solutions in children affected with AH. For this purpose, 78 children with AH were evaluated in a randomised and controlled study. Inclusion criteria for the study required that each patient had to have a III or IV degree of AH on the initial endoscopic examination. Children were treated with intranasal hypertonic or isotonic saline solution for 8 weeks. After treatment, endoscopy was performed to evaluate AH degree. Hypertonic treatment was associated with significant (p<O.05) reduction of AH degree. There was a consistent reduction of children with III degree of AH. No adverse events were reported. This preliminary study demonstrates that an 8-week treatment with intranasal hypertonic solution is associated with significant reduction of AH. Therefore, this study evidences that hypertonic solution may exert an anti-inflammatory activity and is safe.Adenoidal hypertrophy (AH) represents one of the most frequent indications for surgery in children (1). Moreover, AH is associated with significant morbidity ranging from nasal airway obstruction, recurrent otitis media and cronic rhinosinusitis to obstructive sleep apnea and cardiorespiratory syndrome (2-7).It was recently reported that treatment with corticosteroids can decrease the size of AH, both using beclomethasone (8) and fluticasone (9-13). It has also been demonstrated that nasal beclomethasone is capable of decreasing the frequency of adenotonsillectomy (14-17). On the other hand, these preliminary trials are not conclusive as there is no indication of the real effectiveness .and overall duration of adenoidal size reduction. Moreover, corticosteroids may also induce side effects.Recently, preliminary evidence suggested that hypertonic saline nasal sprays alone are effective in treating nasal symptoms in children with seasonal allergic rhinitis (18). Therefore, the present study aimed at evaluating the effect ofintranasal hypertonic solution among children affected by AH.

Inflammation, infection, and allergy of upper airways: new insights from national and real-world studies

“…Nasal irrigation with hypertonic saline significantly reduced the adenoid size in children with adenoid hypertrophy [114]. Salso-sulfide thermal water was successfully used in children with RRI [115].…”