Role of adenoidectomy in chronic nasal obstruction after nasal steroid therapy failure.
OBJECTIVE
To identify clinical characteristics of pediatric patients that failed nasal steroid therapy for management of chronic nasal obstruction and to evaluate the efficacy of adenoidectomy in this subset of patients.


METHODS
Retrospective chart review.


METHODS
Tertiary care academic center.


METHODS
Analysis was performed on children that underwent adenoidectomy between 2011 and 2015 for chronic nasal obstruction refractory to nasal steroids.


RESULTS
Seventy-four cases were identified. Average age of presentation was 3.6years. Pre-operatively, 25.7% of patients had known asthma, 16.2% reported respiratory allergies, and 20.3% reported use of systemic antihistamines. The most common pre-operative symptoms included mouth breathing (82.4%), nasal congestion (81.1%), snoring (71.6%), and rhinorrhea (37.8%). Average adenoid size was 68% pre-operatively. Ninety-eight percent of patients experienced improvement or resolution of their symptoms following adenoidectomy.


CONCLUSIONS
This study demonstrates average rates of respiratory allergies, but high rates of asthma among patients that fail nasal steroid therapy for chronic nasal obstruction. Adenoidectomy is a highly efficacious intervention in this subset of patients.
Head and Neck Institute, 9500 Euclid Ave, Cleveland Clinic Foundation, Cleveland, OH 44195, USA. Electronic address: ciolekp@ccf.org.
Peter J
PJ
Ciolek
Cleveland Clinic Lerner College of Medicine, 9980 Carnagie Ave, Cleveland, OH 44195, USA.
Allen
A
Xu
Head and Neck Institute, 9500 Euclid Ave, Cleveland Clinic Foundation, Cleveland, OH 44195, USA.
Samantha
S
Anne
Head and Neck Institute, 9500 Euclid Ave, Cleveland Clinic Foundation, Cleveland, OH 44195, USA.
Katie
K
Geelan-Hansen
D000233:Adenoidectomy; D000234:Adenoids / Q000601:surgery*; D000281:Administration, Intranasal; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015508:Nasal Obstruction / Q000188:drug therapy / Q000601:surgery*; D012189:Retrospective Studies; D013256:Steroids / Q000008:administration & dosage*; D016896:Treatment Outcome
D013256:Steroids