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Effect of topical mometasone furoate on adenoidal lymphoid tissue: a light microscopic study

Published online by Cambridge University Press:  08 January 2019

M R Ahmed ,
A S Abou-Halawa ,
I H Ibrahim ,
R F Zittoon  and
E F Y Makary
M R Ahmed*
Affiliation:
Department of Otolaryngology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
A S Abou-Halawa
Affiliation:
Department of Otolaryngology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
I H Ibrahim
Affiliation:
Department of Otolaryngology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
R F Zittoon
Affiliation:
Department of Otolaryngology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
E F Y Makary
Affiliation:
Department of Histology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
*
Author for correspondence: Prof Mohamed Rifaat Ahmed, Department of Otolaryngology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt E-mail: m_rifaat@hotmail.com
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Abstract

Background

Adenoid hypertrophy is a common cause of upper airway obstruction, and adenoidectomy is one of the most frequently performed operations in children. Topical nasal steroids can act directly on nasopharyngeal lymphoid tissue to decrease its reactive inflammatory changes and potentially reduce its size.

Objective

To study the light microscopic changes in adenoidal lymphoid tissue after one month of topical steroid use.

Methods

Twenty-six children with adenoid hypertrophy grade 3 scheduled for adenoidectomy were randomly divided into two equal groups: one group received mometasone furoate aqueous nasal spray (Nasonex) 100 mcg/day for four weeks, and a control group received nasal normal saline 0.9 per cent for four weeks. The removed adenoids were examined histopathologically.

Results

Adenoidal tissue from the mometasone group had less reactive germinal centres and less spongiosis compared to the control group. The latter showed proliferating, reactive, variable sized and shaped lymphoid follicles, with congested blood vessels in the interfollicular areas.

Conclusion

The use of intranasal mometasone furoate aqueous nasal spray (Nasonex) for one month reduced adenoidal tissue reactive cellular changes and its vascularity. This is, however, a pilot study; a longer treatment period is needed to assess the effect of treatment on adenoidal size.

Keywords

AdenoidsMometasoneMicroscopyPathology
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 133 , Issue 2 , February 2019 , pp. 106 - 109
Copyright
Copyright © JLO (1984) Limited, 2019 

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Footnotes

Prof M R Ahmed takes responsibility for the integrity of the content of the paper

References

1Hellings, P, Jorissen, M, Ceuppens, JL. The Waldeyer's ring. Acta Otorhinolaryngol Belg 2000;54:237–41Google Scholar
2Gates, GA, Muntz, HR, Gaylis, B. Adenoidectomy and otitis media. Ann Otol Rhinol Laryngol Suppl 1992;155:24–32Google Scholar
3Bykova, VP, Satdykova, GP. Morphofunctional organization of lymphoepithelial organs of the human pharynx [in Russian]. Izv Akad Nauk Ser Biol 2002:463–71Google Scholar
4Koca, CF, Erdem, T, Bayindir, T. The effect of adenoid hypertrophy on maxillofacial development: an objective photographic analysis. J Otolaryngol Head Neck Surg 2016;45:48Google Scholar
5Glade, RS, Pearson, SE, Zalzal, GH, Choi, SS. Coblation adenotonsillectomy: an improvement over electrocautery technique? Otolaryngol Head Neck Surg 2006;134:852–5Google Scholar
6Brown, OE, Manning, SC, Ridenour, B. Cor pulmonale secondary to tonsillar and adenoidal hypertrophy: management considerations. Int J Pediatr Otorhinolaryngol 1988;16:131–9Google Scholar
7Chan, CC, Au, CT, Lam, HS, Lee, DL, Wing, YK, Li, AM. Intranasal corticosteroids for mild childhood obstructive sleep apnea–a randomized, placebo-controlled study. Sleep Med 2015;16:358–63Google Scholar
8Butler, CC, van Der Voort, JH. Steroids for otitis media with effusion: a systematic review. Arch Pediatr Adolesc Med 2001;155:641–7Google Scholar
9Cengel, S, Akyol, MU. The role of topical nasal steroids in the treatment of children with otitis media with effusion and/or adenoid hypertrophy. Int J Pediatr Otorhinolaryngol 2006;70:639–45Google Scholar
10Mi, JP, Fan, YP, Wang, JQ, Xia, WT. Systematic reviews on efficacy and safety of beclomethasone nasal spray in the treatment of chronic adenoid hypertrophy in children [in Chinese]. Zhonghua Yi Xue Za Zhi 2010;90:844–8Google Scholar
11Sobhy, TS. Role of intranasal steroid in the prevention of recurrent nasal symptoms after adenoidectomy. Int J Otolaryngol 2013;2013:603493Google Scholar
12Chohan, A, Lal, A, Chohan, K, Chakravarti, A, Gomber, S. Systematic review and meta-analysis of randomized controlled trials on the role of mometasone in adenoid hypertrophy in children. Int J Pediatr Otorhinolaryngol 2015;79:1599–608Google Scholar
13Penagos, M, Compalati, E, Tarantini, F, Baena-Cagnani, CE, Passalacqua, G, Canonica, GW. Efficacy of mometasone furoate nasal spray in the treatment of allergic rhinitis. Meta-analysis of randomized, double-blind, placebo-controlled, clinical trials. Allergy 2008;63:1280–91Google Scholar
14Kurien, M, Lepcha, A, Mathew, J, Ali, A, Jeyaseelan, L. X-rays in the evaluation of adenoid hypertrophy: it's role in the endoscopic era. Indian J Otolaryngol Head Neck Surg 2005;57:45–7Google Scholar
15Van Kempen, MJ, Rijkers, GT, Van Cauwenberge, PB. The immune response in adenoids and tonsils. Int Arch Allergy Immunol 2000;122:8–19Google Scholar
16Tabe, H, Kawabata, I, Koba, R, Homma, T. Cell dynamics in the germinal center of the human tonsil. Acta Otolaryngol Suppl 1996;523:64–7Google Scholar
17Criscuoli, G, D'Amora, S, Ripa, G, Cinquegrana, G, Mansi, N, Impagliazzo, N et al. Frequency of surgery among children who have adenotonsillar hypertrophy and improve after treatment with nasal beclomethasone. Pediatrics 2003;111:e236–8Google Scholar
18Zhang, L, Mendoza-Sassi, RA, Cesar, JA, Chadha, NK. Intranasal corticosteroids for nasal airway obstruction in children with moderate to severe adenoidal hypertrophy. Cochrane Database Syst Rev 2008;(3):CD006286Google Scholar
19Chadha, NK, Zhang, L, Mendoza-Sassi, RA, Cesar, JA. Using nasal steroids to treat nasal obstruction caused by adenoid hypertrophy: does it work? Otolaryngol Head Neck Surg 2009;140:139–47Google Scholar
20Berlucchi, M, Valetti, L, Parrinello, G, Nicolai, P. Long-term follow-up of children undergoing topical intranasal steroid therapy for adenoidal hypertrophy. Int J Pediatr Otorhinolaryngol 2008;72:1171–5Google Scholar
21Rezende, RM, Silveira, F, Barbosa, AP, Menezes, UP, Ferriani, VP, Rezende, PH et al. Objective reduction in adenoid tissue after mometasone furoate treatment. Int J Pediatr Otorhinolaryngol 2012;76:829–31Google Scholar