Intranasal corticosteroids may improve nasal obstruction symptoms in children with adenoidal hypertrophy

Clinical question: 
How effective are intranasal corticosteroids for improving nasal airway obstruction in children with moderate to severe adenoidal hypertrophy?
Bottom line: 
Limited evidence suggests intranasal corticosteroids may significantly improve nasal obstruction symptoms in children aged 0–12 years with moderate to severe adenoidal hypertrophy, and this improvement may be associated with a reduction of adenoid size. Given the potential clinically relevant benefits and relatively good tolerability of intranasal corticosteroids, these drugs may be indicated as an alternative treatment for children with moderate to severe adenoidal hypertrophy when adenoidectomy is not urgently required or not available.
Caveat: 
Numerous methodological flaws could be observed in the included studies and these may weaken the strength of evidence provided in this review.The trials lasted from 8 to 24 weeks.The optimal duration of treatment, minimum adequate dosage, and risk of adverse events, including adrenal suppression and growth retardation, need to be explored in future studies.
Context: 
Adenoidal hypertrophy is a common childhood condition, and represents one of the most frequent indications for surgery in children. Commonly, medical management is limited to the treatment of concurrent infections and the complications of adenoidal enlargement.¹ 1. Sclafani AP et al. Pediatrics 1998; 101:675–681.
Review CD#: 
CD006286
PEARLS No: 
96
Date: 
October, 2008
Authored by: 
Brian R McAvoy