Role of Mometasone Furoate Nasal Spray in Adenoid Hypertrophy in Children With Osa

Abstract

BACKGROUNDAdenoid hypertrophy is one of the main causes of upper airway obstruction and Obstructive Sleep Apnoea (OSA) in children. Studies have shown that administration of mometasone furoate aqueous nasal spray significantly improved oxygen saturation in children with sleep-disordered breathing.The aim of this study is to evaluate the effect of mometasone furoate aqueous nasal spray on oxygen saturation measured through nocturnal pulse oximetry and quality of life in children with sleep-disordered breathing due to adenoid hypertrophy. MATERIALS AND METHODSEighty children suspected of having sleep-disordered breathing due to adenoid hypertrophy, whose parents were not willing for surgery (Adenoidectomy) were enrolled in a non-controlled clinical trial. Quality of life questionnaire was distributed pre-and post-interventional and the symptoms were scored depending on its frequency of occurrence. Pre-and post-intervention x-ray nasopharynx taken. Pre-and post-intervention nocturnal oxygen saturation monitoring was done and Oxygen Desaturation Index (ODI) as well as desaturation events were recorded. Data was analysed using paired student t-test and Wilcoxon's Signed Rank Tests. RESULTSOut of the 80 study population, 43 were males (53.8 %) and 37 were females (46.2%). Age distribution of the population ranged from 3 to 10 years with a mean age of 6.2 years. The study showed a strong positive correlation between grade of adenoid size and ODI (r -0.790; p < 0.001). All the pulse oximetric parameters improved significantly after drug administration (p < 0.001). There was a significant improvement in the quality of life of these children after the treatment. CONCLUSIONThe study revealed mometasone furoate aqueous nasal spray therapy leads to significant reduction in adenoid size and gives symptomatic relief for children with sleep disordered breathing. It can be recommended as the prime medical treatment modality for children with sleep disordered breathing, as it substantially reduced the morbidity and health care utilisation by these children.

Pengaruh mometasone furoate terhadap kadar Interleukin 6 serum padapenderita hipertrofi adenoid

“…10 Beberapa mekanisme seperti aksi limfolitik secara langsung, inhibisi terhadap proses inflamasi dan perubahan terhadap flora bakteri adenoid dapat menjadi teori untuk menjelaskan mekanisme steroid menurunkan volume jaringan adenoid dan menurunkan keluhan gejala pada hipertrofi adenoid. 12 Pada penelitian ini, pasien dengan hasil foto skull lateral yang lebih rendah memiliki persentase pengecilan ukuran adenoid yang lebih besar. Pada penelitian oleh Goldbart, 13 menunjukkan bahwa jaringan adenoid pada pasien yang mengalami hipertrofi adenoid memiliki glucocorticoid receptor (GR) yang lebih banyak.…”