Joseph Meghna, Krishna Mrinal Murali, Franco Ancy Jenil, Jekov Laura, Sudo Renan Yuji Ura, Cabral Thamiris Dias Delfino
Medical College Thiruvananthapuram, India.
Medical College Thiruvananthapuram, India.
Am J Otolaryngol. 2025 Jan-Feb;46(1):104566. doi: 10.1016/j.amjoto.2024.104566. Epub 2024 Dec 19.
Intranasal mometasone and oral montelukast have been found to be effective for adenoid hypertrophy in children. We aimed to compare the efficacy of combination therapy of mometasone and montelukast versus mometasone alone for adenoid hypertrophy in children.
Following PRISMA guidelines, we systematically searched PubMed, Embase, Cochrane CENTRAL, and ClinicalTrials.gov databases for randomized controlled trials (RCTs) comparing combination therapy of mometasone and montelukast with mometasone alone for adenoid hypertrophy in children. The outcomes of interest were rhinorrhea, snoring, mouth breathing, and adenoid/nasopharynx ratio. Data were pooled using a random effects model to generate mean differences (MD).
3 RCTs comprising a total of 207 patients were included; (combination therapy n = 104 (50.2 %). Rhinorrhea (MD -1.47; 95 % CI -1.85 to -1.09; p < 0.01; I = 0 %), snoring (MD -1.33; 95 % CI -1.65 to -1.00; p < 0.01; I = 0 %), and mouth breathing (MD -1.06; 95 % CI -1.40 to -0.71; p < 0.01; I = 0 %) were significantly lower in patients treated with combination therapy. No difference was observed in the adenoid/nasopharynx ratio between the groups. However, analysis excluding the study with a high risk of bias showed a significant reduction in the adenoid/nasopharynx ratio (MD -10.73; 95 % CI -13.56 to -7.90; p < 0.01; I = 0 %) in the combination therapy group. During the 3-month follow-up period after cessation of treatment, adenoid/nasopharynx ratio, rhinorrhea, snoring, and mouth breathing were significantly lower in the combination therapy group.
In children with adenoid hypertrophy, combination therapy reduced rhinorrhea, snoring, mouth breathing, and adenoid/nasopharynx ratio at the end of the treatment period and 3 months after treatment cessation.
已发现鼻内使用莫米松和口服孟鲁司特对儿童腺样体肥大有效。我们旨在比较莫米松和孟鲁司特联合治疗与单独使用莫米松治疗儿童腺样体肥大的疗效。
遵循PRISMA指南，我们系统检索了PubMed、Embase、Cochrane CENTRAL和ClinicalTrials.gov数据库，以查找比较莫米松和孟鲁司特联合治疗与单独使用莫米松治疗儿童腺样体肥大的随机对照试验（RCT）。感兴趣的结局指标为鼻溢、打鼾、口呼吸以及腺样体/鼻咽比值。使用随机效应模型汇总数据以生成平均差（MD）。
纳入了3项RCT，共207例患者；（联合治疗组n = 104例（50.2%））。联合治疗组患者的鼻溢（MD -1.47；95%CI -1.85至-1.09；p < 0.01；I² = 0%）、打鼾（MD -1.33；95%CI -1.65至-1.00；p < 0.01；I² = 0%）和口呼吸（MD -1.06；95%CI -1.40至-0.71；p < 0.01；I² = 0%）显著更低。两组之间的腺样体/鼻咽比值未观察到差异。然而，排除偏倚风险高的研究后的分析显示，联合治疗组的腺样体/鼻咽比值显著降低（MD -10.73；95%CI -13.56至-7.90；p < 0.01；I² = 0%）。在治疗停止后的3个月随访期内，联合治疗组的腺样体/鼻咽比值、鼻溢、打鼾和口呼吸显著更低。
在腺样体肥大的儿童中，联合治疗在治疗期结束时以及治疗停止后3个月降低了鼻溢、打鼾、口呼吸和腺样体/鼻咽比值。
