Naqi Syed Ali, Ashfaq Ahmad Hassan, Umar Mumtaz Ahmad, Karmani Jais Kumar, Arshad Naveed
Prof. Dr. Syed Ali Naqi, FCPS (ENT). Professor & HOD ENT, Islamabad Medical and Dental College, Islamabad Pakistan.
Dr. Ahmad Hassan Ashfaq, FCPS (ENT). Associate Prof., Rawalpindi Medical University, Rawalpindi, Pakistan.
Pak J Med Sci. 2021 Mar-Apr;37(2):362-366. doi: 10.12669/pjms.37.2.2670.
BACKGROUND & OBJECTIVES: Generally, the blockage of upper respiratory tract in children is seen with the hypertrophy of adenoids and tonsils. Normally for patients with adenoid hypertrophy (AH), Adenoidectomy with or without Tonsillectomy is carried out, however it has its own complications like haemorrhage and recurrence of adenoid tissue. Consequently, therapeutic approach has increased extraordinary consideration rather than surgical procedure. The inflammatory process proposed for AH has prompted the utilization of anti-inflammatory drugs to treat this issue. The objective of this study was to assess the impacts of Montelukast sodium in children with enlarged adenoids.
A randomized controlled trail was performed from April 2018 to March 2019 in the Otorhinolaryngology clinic of Dr. Akbar Niazi Teaching Hospital, Islamabad. In this randomized, placebo treatment-controlled trial, 60 children aged 4-12 years meeting inclusion criteria were isolated into two groups. The study group was treated with Montelukast sodium 5mg consistently for three months while the control group got placebo treatment for a similar timeframe. A questionnaire was filled by parents/ guardians of every child before and after the intervention to evaluate the severity of sleep discomfort, snoring and mouth breathing.
Following 3 months of treatment, significant reduction in size of the adenoids was seen in 76% of study group compared with just 3% of control group getting placebo treatment.
Montelukast sodium seems to be effective in the reduction of the size of adenoids and improvement in clinical manifestations. It can be viewed as a viable option in contrast to surgical treatment in children with hypertrophy of adenoids.
一般来说，儿童上呼吸道阻塞常见于腺样体和扁桃体肥大。对于腺样体肥大（AH）患者，通常会进行腺样体切除术，可伴有或不伴有扁桃体切除术，但该手术有出血和腺样体组织复发等并发症。因此，治疗方法受到了比手术更大的关注。针对AH提出的炎症过程促使人们使用抗炎药物来解决这个问题。本研究的目的是评估孟鲁司特钠对腺样体肿大儿童的影响。
2018年4月至2019年3月在伊斯兰堡阿克巴·尼亚齐博士教学医院的耳鼻喉科诊所进行了一项随机对照试验。在这项随机、安慰剂对照试验中，将60名符合纳入标准的4至12岁儿童分为两组。研究组连续三个月每日服用5毫克孟鲁司特钠，而对照组在相同时间段接受安慰剂治疗。在干预前后，每个孩子的父母/监护人填写一份问卷，以评估睡眠不适、打鼾和口呼吸的严重程度。
治疗3个月后，研究组76%的患儿腺样体大小显著减小，而接受安慰剂治疗的对照组只有3%。
孟鲁司特钠似乎对减小腺样体大小和改善临床表现有效。与腺样体肥大儿童的手术治疗相比，它可被视为一种可行的选择。
