Does atopy influence the effectiveness of treatment of adenoid hypertrophy with mometasone furoate

Background: The effect of topical mometasone for adenoid hypertrophy treatment is well established. Nevertheless, the influence of atopy on this treatment remains ill defined. Objective: This study aims to compare the effects of topical mometasone furoate treatment on the adenoid tissue between atopic and nonatopic children. Methods: Fifty-one children with obstructive respiratory complaints underwent a semistructured clinical questionnaire on nasal symptoms, prick test, and nasoendoscopy. Nasoendoscopic images were digitalized, and both adenoid and nasopharyngeal areas were measured in pixels; the relative adenoid/ nasopharyngeal area was calculated. Patients were initially treated for 40 days with nasal saline solution. In a subsequent 40-day period, topical mometasone furoate (total dose, 100 g/day) was used. Results: Topical mometasone significantly improved nasal obstruction, snoring, and apnea and also significantly reduced the adenoid tissue area related to the nasopharynx (p 0.0001). Treatment with this glucocorticoid was not influenced by atopy, neither for symptoms nor for adenoid area. Conclusion: Topical mometasone furoate significantly reduced the adenoid tissue area and led to a supplementary improvement of nasal symptoms. This improvement was similar for atopic and nonatopic patients. (Am J Rhinol Allergy 29, 54–56, 2015; doi: 10.2500/ajra.2015.29.4126) C hronic respiratory obstruction leads to substantial changes in the neurocognitive response and in facial morphology. Therefore, diagnosis and treatment of respiratory obstruction should be anticipated to avoid major complications. Adenoid hypertrophy and chronic rhinitis are the leading factors causing respiratory obstruction, and these two entities are frequently observed in the same patient.1 Because allergic inflammation may be related to adenoid edema, it is generally believed that patients with allergic rhinitis may be predisposed to larger adenoid tissue and more prominent symptoms than patients without allergy. Treatment of adenoid hypertrophy with topical corticosteroids has been largely reported in the literature, and most studies show that this treatment approach may be very useful for improving symptoms2–8 and decreasing adenoid tissue size.3,6,7 Among the available corticosteroids, mometasone furoate has been demonstrated to be very safe in children older than two years.9,10 Nevertheless, little has been explored regarding the influence of atopy on this treatment outcome. Thus, the present study aims to evaluate the effect of nasal mometasone furoate treatment in children with adenoid hypertrophy, comparing the group with associated allergic rhinitis to those without allergy.