Is the effect of topical intranasal steroids on obstructive adenoids transient or long-lasting? Case series and systematic review of literature.

OBJECTIVES: To study and review the short- and long-term effects of intranasal steroids on obstructive adenoids.

METHODS: In this prospective cohort study, 19 children previously treated with mometasone furoate for 3 months were contacted at 3, 6 and 12 months after cessation of treatment. Main outcome measures included: change in severity of nasal obstruction, allergic rhinitis and obstructive symptoms. A systematic review of literature was also performed.

RESULTS: By one year, 25 per cent of patients required adenoidectomy; the remaining children had no significant change in clinical score (p = 0.464), obstruction severity (p = 0.191) or allergic symptoms (p = 0.284). Fourteen pertinent studies were identified; all but one study showed improvement in the patients' symptoms and/or degree of obstruction. Two studies with follow up reaching 25 months showed positive effects.

CONCLUSION: The short-term positive effect of some intranasal steroids on obstructive adenoids seems to persist in a significant number of patients after the cessation of treatment.