Steroid Nasal Spray versus Curettage Adenoidectomy in School Children – A Randomized Controlled Trial

Background: Management of chronic adenoiditis is planned according to the degree of airway obstruction, age of the patient and related morbidity.Considering the individual risk analysis of patients in terms of anesthetic, post-operative complications and recurrence, non-surgical treatment could be considered in patients who are unfit for surgery.Methods: Randomized control trial was conducted to compare the effects of topical nasal steroid spray with curettage adenoidectomy in chronic adenoiditis.Post intervention, patients were followed up for 6months.Results: Out of 103 patients, 51 were subjected to adenoidectomy and 52 to medical treatment.At the end of 6months, 49 (Negative rank score) patients of surgical group and 48 (Negative rank score) patients of medical group showed statistically significant improvement (p<.001) in symptoms and regression of adenoid size.There was no statistically significant difference between groups with respect to recurrent cold, running nose, epistaxis and ear symptoms (p>.05).Conclusion: Topical nasal steroid spray can be used as an alternative treatment in chronic adenoiditis when surgery is contraindicated.It can also be considered when surgery needs to be postponed at the request of the patient.