Background. Intranasal steroid provides an efficient nonsurgical alternative to adenoidectomy for theimprovement of adenoid nasal obstruction. Objective. To demonstrate the role of intranasal steroid in the prevention of adenoid regrowth after adenoidectomy. Methods. Prospective randomized controlled study. Two hundred children after adenoidectomy were divided into 2 groups. Group I received postoperative intranasal steroid and group II received postoperative intranasal saline spray. Both medications were administered for 12 weeks postoperatively. Patients were followed up for 1 year. Followup was done using the nasopharyngeal lateral X-rays, reporting the degree of the symptoms. Results. Significant difference between both groups after 6 months and after 1 year. The intranasal steroid group had significantly lower score after 6 months and after 1 year as regards nasal obstruction, nasal discharge, and snoring than the intranasal saline group. 2 weeks postoperatively, there was no difference between both groups as regards nasal obstruction, discharge, or snoring. As regards lateral radiographs, there was statistically significant difference between both groups 1 year but not 6 months postoperatively. Conclusion. Factors influencing the outcome of intranasal steroids therapy in the prevention of adenoid regrowth have not been identified. However, this treatment may obtain successful results in children to avoid readenoidectomy. 1. Introduction Nasal obstruction is one of the main symptoms of adenoid hypertrophy; they are also presented with chronic rhinorrhea, snoring, hyponasal speech, and obstructive sleep disorder [1]. Adenoidectomy can reduce both nasal obstructions and upper respiratory infections. However, some patients display clinically significantly persistent nasal symptoms even after surgery. Symptoms, such as nasal obstruction or recurrent upper respiratory infections, persist in 19–26% of patients [2]. Adenoidectomy remains a commonly performed procedure, although it produces short-term benefits [3]. There are 2 difficulties that have been described to prevent complete adenoidal removal. Firstly, lymphoid tissue in the pharyngeal recess is considered by all authors as difficult to remove [4]. The second difficulty is the bulging adenoidal tissue into the posterior choanae, which was addressed by Pearl and Manoukian [5]; they found choanal adenoids in 9% of their study group. Although there are few nonsurgical alternative treatment options, these may be considered in less serious cases. Accordingly, studies about intranasal steroid
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