The Efficacy of Mometasone Furoate Nasal Spray in the Treatment of Adenoidal Hypertrophy in Children

Objectives: Realize whether the adenoid size and severity of chronic nasal obstruction symptoms may decrease with intranasal mometasone furoate application in children affected with adenoidal hypertrophy. Methods: Forty children with severe adenoidal hypertrophy (aged between 4-12 years) were recruited between August 2012 and April 2013 in a prospective randomized clinical trial. Primary nasal endoscopy showed more than 75% choanal obstruction in all patients. Subjects were randomly divided into 2 groups. The study group (n = 20) underwent mometasone nasal spray treatment (100 micrograms per nostril every 12 hours) for 4 weeks, and the control group (n = 20) received saline solution nasal spray as placebo in the same manner. Adenoid size and subjective symptoms were evaluated and compared between the 2 groups. Results: At the start of the experiment, there was no significant difference in the mean scores for any of the subjective symptoms (nasal obstruction, snoring, mouth breathing) between the 2 treatment groups. At the end of 4 weeks, statistically significant improvement was observed in total subjective symptom scores with mometasone treatment compared with placebo (P < .05). A significantly greater number of patients in the study group showed a reduction in adenoid size compared with the control group (70% versus 20%, P = .001). Conclusions: Treatment with mometasone furoate nasal spray causes a substantial improvement in nasal obstruction symptoms and reduction in size of adenoid in children with adenoidal hypertrophy and may obviate the need for surgery in these patients.