Histopathological effects of intranasal mometasone furoate on adenoidal tissue in children undergoing adenoidectomy

Abstract

Aims: Adenoidal hypertrophy is a major contributor to upper airway obstruction and sleep-disordered breathing in children. Although intranasal corticosteroids (INCS) are clinically effective in alleviating symptoms, their histopathological effects on adenoidal tissue remain underexplored. This study aimed to evaluate the histopathological changes in adenoidal tissue following preoperative intranasal mometasone furoate therapy in pediatric patients undergoing adenoidectomy. Methods: This retrospective cross-sectional study included 96 children aged 2–18 years who underwent adenoidectomy between 2022 and 2024. Patients were divided into two groups: group 1 (no steroid therapy) and group 2 (received intranasal mometasone furoate 100 mcg/day for six weeks preoperatively). All patients used saline nasal irrigation during the same period. Adenoidal tissue samples were assessed histopathologically using semi-quantitative scoring (0–3) for follicular hyperplasia, chronic inflammation, acute inflammation, and goblet cell hyperplasia. Binary parameters including fibrosis, atrophy, ulceration, and hemorrhage were also evaluated. Results: Group 2 exhibited significantly lower levels of follicular hyperplasia (median score 1.0 vs. 3.0, p<0.001), acute inflammation (0.0 vs. 1.0, p<0.001), and goblet cell hyperplasia (p=0.048) compared to group 1. No significant differences were observed in chronic inflammation, fibrosis, atrophy, ulceration, or hemorrhage. Conclusion: Preoperative intranasal mometasone furoate significantly reduces certain inflammatory and hyperplastic histopathological features of adenoidal tissue in children. These findings support its use as a non-surgical treatment option for selected cases of adenoidal hypertrophy and warrant further prospective research.

Keywords

• Adenoid hypertrophy
• mometasone furoate
• intranasal corticosteroids
• histopathology
• adenoidectomy

Histopathological effects of intranasal mometasone furoate on adenoidal tissue in children undergoing adenoidectomy

Abstract

Aims: Adenoidal hypertrophy is a major contributor to upper airway obstruction and sleep-disordered breathing in children. Although intranasal corticosteroids (INCS) are clinically effective in alleviating symptoms, their histopathological effects on adenoidal tissue remain underexplored. This study aimed to evaluate the histopathological changes in adenoidal tissue following preoperative intranasal mometasone furoate therapy in pediatric patients undergoing adenoidectomy. Methods: This retrospective cross-sectional study included 96 children aged 2–18 years who underwent adenoidectomy between 2022 and 2024. Patients were divided into two groups: group 1 (no steroid therapy) and group 2 (received intranasal mometasone furoate 100 mcg/day for six weeks preoperatively). All patients used saline nasal irrigation during the same period. Adenoidal tissue samples were assessed histopathologically using semi-quantitative scoring (0–3) for follicular hyperplasia, chronic inflammation, acute inflammation, and goblet cell hyperplasia. Binary parameters including fibrosis, atrophy, ulceration, and hemorrhage were also evaluated. Results: Group 2 exhibited significantly lower levels of follicular hyperplasia (median score 1.0 vs. 3.0, p<0.001), acute inflammation (0.0 vs. 1.0, p<0.001), and goblet cell hyperplasia (p=0.048) compared to group 1. No significant differences were observed in chronic inflammation, fibrosis, atrophy, ulceration, or hemorrhage. Conclusion: Preoperative intranasal mometasone furoate significantly reduces certain inflammatory and hyperplastic histopathological features of adenoidal tissue in children. These findings support its use as a non-surgical treatment option for selected cases of adenoidal hypertrophy and warrant further prospective research.

Keywords

• Adenoid hypertrophy
• mometasone furoate
• intranasal corticosteroids
• histopathology
• adenoidectomy

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