Published Paper Details:

Aim: A common cause of nasal obstruction in children is adenoid hypertrophy. It is an indication for surgical management of nasal obstruction along with deviated nasal septum and antro choanal polyp in children due to effect on growth of children due to these conditions. If the symptoms are severe due to adenoid hypertrophy usually adenoidectomy is recommended in most of cases, however cleft palate, bleeding disorders and anaemia being contraindications of surgery, parents also get frightened when they are advised about surgery, we in our study tried to see effectiveness of nasal steroid spray and Oxymetazoline combination in adenoid hypertrophy. The safety of use of nasal steroid spray for longer duration has been studied and proved by various studies. The aim of the current study is to determine the effectiveness of mometasone nasal spray with Oxymetazoline nasal spray in treatment of children with adenoid hypertrophy presenting as nasal obstruction and mouth breathing. Methods: This prospective study was conducted in the department of Health and family welfare Civil Hospital Jwalamukhi Himachal Pradesh by combined efforts of ENT and Paediatrics doctors on 25 children who met the inclusion criteria over a period of 9 months. They were diagnosed on the basis of history taken from parents, examination done by physician and X-ray nasopharynx. Before starting of treatment a pre-treatment scoring was accessed. All children were given mometasone furoate nasal spray (for 3 months) and Oxymetazoline nasal drops (for 14 days) therapy and then children were evaluated every monthly for next 3 months and scoring on the basis of symptoms was done on every visit. X ray nasopharynx were repeated after three months of treatment. Results: During the 3 months follow up after starting the treatment, a significant improvement in symptom of nasal obstruction was seen in 64% patients and 60% patients showed improvement in snoring after one month treatment, which increased to 85.6% and 83% respectively after completion of 3 months treatment. X ray nasopharynx taken after 3 months of treatment showed reduction in grading of adenoids in 82% of total patients. 2 patients did not showed good improvement after treatment and they were referred to higher centre for adenoidectomy. Although longer follow up is required for exact results but our study established that a long term Mometasone Furoate nasal spray use could be an alternative to adenoidectomy in children whose parents are not willing for surgery or the children who have contraindication for surgery. Conclusions: In patients where adenoidectomy is contraindicated and parents who are not willing for surgery, long term mometasone furoate nasal spray with short term Oxymetazoline nasal drops treatment has good outcome as a treatment option for nasal obstruction due to adenoid hypertrophy.