Use of intranasal corticosteroids in adenotonsillar hypertrophy

Sakarya, Engin Umut; Muluk, Nuray Bayar; Şakalar, Emine Güven; Şentürk, Mehmet Baki; Arıcıgil, Mitat; Bafaqeeh, Sameer Ali; Cingi, Cemal

doi:10.1017/s0022215117000408

Cited by 31 publications

(25 citation statements)

References 58 publications

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“…In this study, 76% of patients who were previously recommended surgery did not require intervention. In addition to symptomatic improvement, intranasal corticosteroids have also been shown to decrease rates of surgery for adenoid hypertrophy [68]. Studies have also examined the effect of steroid nasal spray after adenoidectomy and found that administration significantly prevented regrowth and obstructive nasal symptoms if administered 3 weeks post-adenoidectomy [69].…”

Section: Non-surgical Therapy For Adenoid Hypertrophymentioning

confidence: 99%

Adenoidectomy in Children: What Is the Evidence and What Is its Role?

Schüpper

Nation

Pransky

2018

Curr Otorhinolaryngol Rep

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Purpose of Review Review the current state of the adenoidectomy procedure in the pediatric population with up-to-date indications for surgery, operative techniques, adverse events, non-surgical management of adenoid hypertrophy, and future directions. Recent Findings Adenoidectomy is indicated in children for the treatment of sleep-disordered breathing, nasal airway obstruction, recurrent acute otitis media, and chronic rhinosinusitis. A new recommendation was released in 2016, not supporting adenoidectomy for a primary indication of otitis media in children under 4 years old, including those with prior tympanostomy tubes, unless a distinct indication exists such as nasal obstruction or chronic adenoiditis. Although adenotonsillectomy is the mainstay of treatment for obstructive sleep apnea (OSA), recent studies have identified that non-obese patients with moderate OSA and small tonsils have comparable benefits with adenoidectomy alone with less complications. While conventional approaches such as indirect mirror-assisted curette and suction coagulation are still utilized, direct transnasal endoscopeassisted removal of the adenoids has proven to be a safe technique, with good short-and long-term outcomes. Novel nonsurgical therapies including immunotherapy have been evaluated. Summary Adenoidectomy is a safe procedure in the pediatric population and leads to excellent outcomes. Adverse events are rare, and hospitalization is uncommon. Children with sleep disturbance from nasal airway obstruction, ear disease, or chronic rhinosinusitis are the best operative candidates for this procedure.

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Section: Non-surgical Therapy For Adenoid Hypertrophymentioning

confidence: 99%

Adenoidectomy in Children: What Is the Evidence and What Is its Role?

Schüpper

Nation

Pransky

2018

Curr Otorhinolaryngol Rep

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“…AR is a nasal allergic disease characterized by systemic and nasal overproduction of immunoglobulin E (IgE) skewing of mucosal immune homeostasis toward a TH2-type response, and recall of eosinophils and mast cells (Hyun et al, 2018 ). AH is characterized by hypertrophy of the adenoid tonsil, as a consequence of different antigenic stimulation triggering chronic inflammation (Sakarya et al, 2017 ). AR and AH cause the obstruction and the increase in airflow resistance in the upper airway (Ballikaya et al, 2018 ).…”

Section: Introductionmentioning

confidence: 99%

16S Metagenomics Reveals Dysbiosis of Nasal Core Microbiota in Children With Chronic Nasal Inflammation: Role of Adenoid Hypertrophy and Allergic Rhinitis

Migliori

Zicari

Aleandri

et al. 2020

Front. Cell. Infect. Microbiol.

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Allergic rhinitis (AR) and adenoid hypertrophy (AH) are, in children, the main cause of partial or complete upper airway obstruction and reduction in airflow. However, limited data exist about the impact of the increased resistance to airflow, on the nasal microbial composition of children with AR end AH. Allergic rhinitis (AR) as well as adenoid hypertrophy (AH), represent extremely common pathologies in this population. Their known inflammatory obstruction is amplified when both pathologies coexist. In our study, the microbiota of anterior nares of 75 pediatric subjects with AR, AH or both conditions, was explored by 16S rRNA-based metagenomic approach. Our data show for the first time, that in children, the inflammatory state is associated to similar changes in the microbiota composition of AR and AH subjects respect to the healthy condition. Together with such alterations, we observed a reduced variability in the between-subject biodiversity on the other hand, these same alterations resulted amplified by the nasal obstruction that could constitute a secondary risk factor for dysbiosis. Significant differences in the relative abundance of specific microbial groups were found between diseased phenotypes and the controls. Most of these taxa belonged to a stable and quantitatively dominating component of the nasal microbiota and showed marked potentials in discriminating the controls from diseased subjects. A pauperization of the nasal microbial network was observed in diseased status in respect to the number of involved taxa and connectivity. Finally, while stable co-occurrence relationships were observed within both control- and diseases-associated microbial groups, only negative correlations were present between them, suggesting that microbial subgroups potentially act as maintainer of the eubiosis state in the nasal ecosystem. In the nasal ecosystem, inflammation-associated shifts seem to impact the more intimate component of the microbiota rather than representing the mere loss of microbial diversity. The discriminatory potential showed by differentially abundant taxa provide a starting point for future research with the potential to improve patient outcomes. Overall, our results underline the association of AH and AR with the impairment of the microbial interplay leading to unbalanced ecosystems.

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“…Lastly, OSA has been addressed with anti inflammatory drugs, such as some intra-nasal steroids. However, these treatments are mostly given to children [136,137]. It is our understanding that no solid evidence of using steroids inhaled through the nose may reduce symptoms of OSA in aging population.…”

Section: Therapeutical Approaches For Managing Sleep Disorders In Agingmentioning

confidence: 99%

Therapeutic Approaches for the Management of Sleep Disorders in Geriatric Population

Salas-Crisóstomo

Torterolo

Veras

et al. 2019

CMC

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Use of intranasal corticosteroids in adenotonsillar hypertrophy

Abstract: Intranasal corticosteroids have been used in adenoidal hypertrophy and adenotonsillar hypertrophy patients, decreasing rates of surgery for adenotonsillar hypertrophy.

Cited by 31 publications

References 58 publications

Adenoidectomy in Children: What Is the Evidence and What Is its Role?

Adenoidectomy in Children: What Is the Evidence and What Is its Role?

16S Metagenomics Reveals Dysbiosis of Nasal Core Microbiota in Children With Chronic Nasal Inflammation: Role of Adenoid Hypertrophy and Allergic Rhinitis

Therapeutic Approaches for the Management of Sleep Disorders in Geriatric Population

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