Clin Exp Otorhinolaryngol.  2011 Mar;4(1):27-32.

Role of Intranasal Topical Steroid in Pediatric Sleep Disordered Breathing and Influence of Allergy, Sinusitis, and Obesity on Treatment Outcome

• Jung YG
• Kim HY
• Min JY
• Dhong HJ
• Chung SK

Abstract

OBJECTIVES
To evaluate efficacy of short term intranasal corticosteroid (mometasone furoate) treatment in pediatric sleep-disordered breathing (SDB) patients.
METHODS
A prospective, observational study was done. A total of 41 children (2-11 years old) were enrolled into this study. All patients received 4-weeks course of mometasone furoate 100 microg/day treatment. They were evaluated at pretreatment and immediately after treatment with obstructive sleep apnea (OSA)-18 quality of life survey and lateral neck X-ray. Also, the assessment of each patients included history, skin prick test or CAP test, and sinus radiography. We compared the OSA-18 survey score and adenoidal-nasopharyngeal (AN) ratio between before and after treatment.
RESULTS
Total OSA-18 score and AN ratio decreased significantly after treatment regardless of allergy, sinusitis, and obesity (P=0.003, P=0.006). There was no complication after treatment of mometasone furoate.
CONCLUSION
Pediatric SDB patients with adenoid hypertrophy could be effectively treated with 4-weeks course of mometasone furoate. Allergy, obesity, and sinusitis did not affect on the result of treatment.

Keyword

Steroid; Topical administration; Sleep disorder; Adenoid; Pediatrics; Allergy

MeSH Terms

Adenoids
Administration, Topical
Child
Humans
Hypersensitivity
Hypertrophy
Neck
Obesity
Pediatrics
Pregnadienediols
Prospective Studies
Quality of Life
Sinusitis
Skin
Sleep Apnea Syndromes
Sleep Apnea, Obstructive
Treatment Outcome
Mometasone Furoate
Pregnadienediols

Figure

• 

  Fig. 1 Method of assessing adenoid enlargement on lateral neck radiography. In this method the adenoidal measurement (A) represents the distance from the point of maximal convexity of the adenoid shadow to a line along the anterior margin of the basiocciput. The nasopharyngeal measurement (N) is the distance between the posterior border of the hard palate and the antero-inferior edge of the sphenobasioccipital synchondrosis.

• 

  Fig. 2 Comparison of symptom score between pre and post-4weeks course of topical steroid treatment. S: sleep disturbance; P: physical suffering; E: emotional distress; D: daytime problems; C: caregiver concerns. *P<0.05.

• 

  Fig. 3 Comparison of adenoid-nasopharyngeal (AN) ratio between pre and post-4weeks course of topical steroid treatment. *P<0.05.

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