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Topical steroids for nasal airway obstruction in children with moderately to severely enlarged adenoids

Adenoidal hypertrophy is generally considered a common condition of childhood and represents one of the most frequent indications for surgery in children. In less severe cases, non‐surgical interventions may be considered, however few medical alternatives are currently available. This review was conducted to assess the effectiveness of intranasal corticosteroids for improving nasal airway obstruction in children aged 0 to 12 years with moderate to severe adenoidal hypertrophy. Evidence derived from five of the six randomised controlled trials included in this review suggests that intranasal steroids may significantly improve symptoms of nasal obstruction in children with adenoidal hypertrophy and that this improvement may be associated with the reduction of adenoid size. One study did not find a significant improvement in nasal obstruction symptoms. Further large and high‐quality randomised controlled trials are warranted.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

How do the tonsils work?

The tonsils are part of the body’s defense system. Because of their location at the throat and palate, they act as “guards.” They come into contact with germs especially soon after they enter through the mouth or the nose. This allows them to activate the immune system early.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: January 7, 2015

Anti‐inflammatory drugs for the treatment of obstructive sleep apnea in children

Obstructive sleep apnea (OSA) is the partial or complete blockage of the upper airways during sleep and affects about 1% to 4% of children. The most common underlying reason for OSA in children is enlarged tonsils. Surgical removal of the enlarged tonsils is the therefore currently the treatment standard. In milder cases of OSA, treatment with anti‐inflammatory drugs to reduce the size of the tonsils is an alternative to surgery. The aim of this review was to evaluate the effectiveness of anti‐inflammatory drugs for the treatment of OSA in children between one and 16 years of age. A comprehensive literature search identified three relevant studies. Very limited evidence from these studies suggests that steroids inhaled through the nose may reduce symptoms of OSA in children. Further studies are needed to evaluate anti‐inflammatory drugs for OSA in children.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Middle ear infection: Overview

Acute middle ear infections among the most common illnesses in babies and young children. Parents often have sleepless nights when their child has a middle ear infection. The child may cry a lot, have an earache, run a fever and be unable to sleep.But middle ear infections generally clear up on their own within two to three days, and serious complications are rare.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: December 1, 2016

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