S202 Abstracts J ALLERGY CLIN IMMUNOL

FEBRUARY 2004
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Chronic Nonallergic Rhinitis in Children: Role of Adenoidal
Hypertrophy
M. Rama, E. Yousef, S. J. McGeady; Allergy-Immunology, A.I. duPont
Hospital for Children/Thomas Jefferson University, Wilmington, DE.
RATIONALE: The contribution of adenoidal hypertrophy (AH) to nasal
symptoms of non-allergic rhinitis (NAR) is unknown. The primary out-
come of this study was the prevalence of adenoidal hypertrophy in chil-
dren with NAR. Secondary outcome was ability of intranasal glucocorti-
coids (INS) to reduce AH and related symptoms.
METHODS: Symptoms suggesting allergic rhinitis were found in 294
children aged 1-15 years. Those with negative skin tests (ST) to a panel of
environmental allergens, and AH on lateral neck X-ray were the study
group. The benefit of INS was assessed by symptom score comparisons
before and after therapy and X-ray changes.
RESULTS: Negative ST were found in 147/294 (50%) of subjects who
were then diagnosed with NAR. Of these 41/147 (28%) had AH. In the
AH group symptoms included rhinorrhea 26/41 (63%), snoring 20/41
(48%), mouth breathing 18/41 (43%), nasal congestion 18/41 (43%),
recurrent sinusitis/otitis media 7/41 (17%). Of AH patients 35/41 (85%)
were treated with INS resulting in 18/35 (51%) reporting symptomatic
improvement, and 5/35 (14%) being unchanged; in 12/35 (34%) there is
no follow up. Repeat X-rays were done in 7/35 (20%) and revealed
improvement of adenoid size in 2/7 (28%), no change in 3/7 (42%) and
further enlargement in 1/7 (14%).
CONCLUSIONS: Our study reveals that AH is often associated with
NAR in children. Use of INS leads to symptomatic improvement in
approximately 50% of cases, and may reduce adenoidal size in a subset of
cases. In children with NAR a trial of INS therapy seems reasonable prior
to surgical intervention.
Funding: Self-funded