Abstract
Background Adenoid Hypertrophy (AH) results in symptoms ranging from mild nasal obstruction to the dangerous obstructive sleep apnoea. Normally for such patients Adenoidectomy with or without Tonsillectomy is carried out. However complications like haemorrhage and recurrence of adenoid tissue are common. Thus, non-surgical therapies have attracted considerable attention as an alternative strategy. The present study is aimed at evaluating the effect of oral Montelukast, a cysteinyl- leukotriene receptor antagonist, in children with AH.
Materials and Methods Sixty children aged between 6 and 12 years with adenoid hypertrophy were randomly divided into two groups of thirty each. The study group was prescribed Tablet Montelukast 5 mg daily for 12 weeks while the control group received matching placebo. A questionnaire based upon the severity of the symptoms as well as the Adenoid Nasopharynx ratio (A/N), as measured via X-ray Adenoids and the Nasal endoscopic scores done before and after treatment (at 3 months) in the two groups were taken into consideration .
Results The Mann Whitney Test which was used found no distinction in snoring, sleep discomfort and mouth breathing between the two groups before the start of treatment. But a significant difference was indeed observed between the two groups after treatment in case of snoring (P < 0.006), sleep discomfort(P < 0.001) and mouth breathing (P < 0.001).
Conclusion Oral Montelukast therapy is seen to be effective not only in the reduction of the size of adenoids but also in improvement of the overall symptoms and can thus be considered as a viable alternative .
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Liming BJ, Ryan M, Mack D, Ahmad I, Camacho M (2019) Montelukast and Nasal Corticosteroids to Treat Pediatric Obstructive Sleep Apnea: A Systematic Review and Meta-analysis. Otolaryngology-Head and Neck Surgery 160(4):594–602
Saedi B, Sadeghi M, Mojtahed M, Mahboubi H (2011) Diagnostic efficacy of different methods in the assessment of adenoid hypertrophy. Am J Otolaryngol 32(2):147–151
Kheirandish Gozal L, Bandla HP, Gozal D (2016) Montelukast for children with obstructive sleep apnea: Results of a double-blind, randomized, placebo-controlled trial. Annals of the American Thoracic Society 13(10):1736–1741
Babakurban ST, Aydın E (2016) Adenoidectomy: Current approaches and review of the literature. Kulak Burun BogazIhtis Derg 26(3):181–190
Berlucchi M, Salsi D, Valetti L, Parrinello G, Nicolai P (2007) The role of montelukast in the treatment of adenoidal hypertrophy in the pediatric age group: preliminary results of a prospective, randomized study. Pediatrics 119(6):e1392–e1397
Mizutani N, Nabe T, Imai A, Sakurai H, Takenaka H, Kohno S (2001) Markedly increased nasal blockage by intranasal leukotriene D4 in an experimental allergic rhinitis model: contribution of dilated mucosal blood vessels. Jpn J Pharmacol 86(2):170–182
Dayyat E, Serpero LD, Kheirandish-Gozal L, Goldman JL, Snow A, Bhattacharjee R et al (2009) Leukotriene pathways and in vitro adenotonotonsillar cell proliferation in children with obstructive sleep apnea. Chest 135(5):1142–1149
Bozkurt MK, Tulek B, Bozkurt B, Akyürek N, Mehmet ÖZ et al (2014) Comparison of the efficacy of prednisolone, montelukast, and omalizumab in an experimental allergic rhinitis model. Turk J Med Sci 44(3):439–447
Cohen D, Konak S (1985) The evaluation of radiographs of the nasopharynx. Clin Otolaryngol Allied Sci 10(2):73–78
Caylakli F, Hizal E, Yilmaz I, Yilmazer C (2009) Correlation between adenoid-nasopharynx ratio and endoscopic examination of adenoidhypertrophy: a blind, prospective clinical study. Int J Pediatr Otorhinolaryngol 73(11):1532–1535
Shokouhi F, Jahromi AM, Majidi MR, Salehi M (2015) Montelukast in adenoid hypertrophy: Its effect on size and symptoms. Iran J Otorhinolaryngol 27:443–448
Goldbart AD, Goldman JL, Veling MC, Gozal D (2005) Leukotriene modifier therapy for mild sleep-disordered breathing in children. Am J Respir Crit Care Med 172(3):364–370
Tuhanıoğlu B, Erkan SO (2017) Evaluation of the effects of montelukast mometasone furoate and combined therapy on adenoid size: A randomized prospective clinical trial with objective data. Turk J Med Sci 47(6):1736–1743
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Source of financial Support
The present study did not receive any specific grant from any funding agencies. No funding agency has participated in writing or in submission of the manuscript.
Conflict of Interest and Informed Consent
The authors declare no conflicts of interest with respect to the research and publication of this article and that the procedures were conducted with the understanding and the consent of the patient and their parents.
The manuscript has been read and approved by all the authors. It has been cleared by Tata Main Hospital Ethical Committee (approval no - TMH/EC/21/151,166).
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Baruah, B., Gupta, A., Kumar, A. et al. The Role of Montelukast Sodium in Children with Adenoid Hypertrophy - A Comparative Study. Indian J Otolaryngol Head Neck Surg 75, 306–310 (2023). https://doi.org/10.1007/s12070-022-03167-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12070-022-03167-1