KBB-Forum 2018 , Cilt 17, Sayı 3

ROLE OF SHORT-TERM ORAL CORTICOSTEROID IN PEDIATRIC SLEEP DISORDERED BREATHING AND ADENOID HYPERTROPHY ON TREATMENT OUTCOME

Sevinç BAYRAK1, MD; Ekrem Said KANKILIÇ1, MD; Ali Osman KÖKSAL2, MD; Mehtap ACAR3, MD; Ayşe TÜRKMEN2, MD; Selen GÜLER2, MD
1Keçiören Eğitim ve Araştrıma Hastanesi, Kulak Burun Boğaz Baş ve Boyun Cerrahisi, Ankara, Türkiye
2Keçiören Eğitim ve Araştırma Hastanesi, Pediatri Kliniği, Ankara, Türkiye
3Dr. Sami Ulus Çocuk Hastalıkları Eğitim ve Araştırma Hastanesi, Pediatri Kliniği, Ankara, Türkiye
Introduction and objectives: Adenoid hypertrophy and sleep disordered breathing (SDB) are generally considered common diseases of childhood. Oral corticosteroids have been used to treat upper airway blockages through their anti-inflammatory and lympholytic impacts. Although nasal corticosteroids are widely used in adenoid hypertrophy, there are few information about the effects of oral corticosteroids to the adenoid tissue. We supposed that oral corticosteroid treatment may be helpful in adenoid hypertrophy due to its inflammatory related background. According to this idea we evaluated the effect of short-term oral corticosteroid treatment on adenoid hypertrophy in patients receiving oral corticosteroids for any other reasons.

Methods: A prospective, observational study was conducted. In total, 51 children (2–11years old) were enrolled into this study. All patients received a 3-day course of oral corticosteroid (1 mg/kg) treatment. They were evaluated before treatment and immediately after treatment with the obstructive sleep apnea (OSA)-18 quality of life survey and a transnasal endoscopic examination. In addition, the evaluation of each patient included history, physical examination, and blood tests. We compared the OSA-18 survey score and adenoid size between before and after treatment.

Results: The total OSA-18 score and adenoid size reduced significantly after treatment (P<0.001). There was no complication after treatment with an oral corticosteroid.

Conclusion: We observed reduction in adenoid size and symptomatic healing of SDB according to the OSA-18 score with 3-day course of oral corticosteroid. Without knowing the long term efficiency and systemic effect results of 3-day oral corticosteroid, it shouldn’t be used as a routine treatment for adenoid hypertrophy and SDB. Keywords :