Effectiveness and safety of intranasal corticosteroids for adenoid Hypertrophy: A systematic review and meta-analysis

Abstract

Background

Adenoid hypertrophy is a common condition that can lead to significant symptoms and possibly complications. Intranasal corticosteroids have emerged as a promising non-surgical treatment for this condition. Our study aims to evaluate the effectiveness and safety of intranasal corticosteroids in managing it.

Methods

From inception to November 2024, we conducted a thorough search across four electronic databases. Our study included all available research comparing intranasal corticosteroids to any comparator in managing adenoid hypertrophy. The study's outcomes were the rate of adenoidectomy, post-treatment clinical symptoms scores, adenoid hypertrophy grade, adenoid size, and adverse effects. The categorical variables were pooled as risk ratios (RR). Continuous outcomes were pooled using the standardized mean differences (SMD) with a 95 % confidence interval (CI).

Results

Thirty studies involving 2301 children with adenoid hypertrophy were included in our analysis. Our pooled results showed a lower rate of adenoidectomy in patients treated with intranasal corticosteroids compared to the control group (RR = 0.30, 95 % CI [0.17 to 0.54], P < 0.0001). The intranasal corticosteroids group also exhibited a significantly lower overall clinical symptoms score (SMD = −0.81, 95 % CI [-1.01 to −0.60], P < 0.00001) and smaller adenoid size (SMD = −1.33, 95 % CI, [-1.91 to −0.75], P < 0.00001).

Conclusion

Intranasal corticosteroids are effective for treating adenoid hypertrophy, as they reduce adenoid size, improve clinical symptoms, and decrease the need for adenoidectomy. Clinicians should incorporate intranasal corticosteroids into treatment regimens to alleviate clinical symptoms and potentially avoid surgery. To support our results, further large-scale randomized controlled trials with extended follow-up periods are recommended.