Jurnal Reading

Role of mometasone furoate aqueous nasal

spray for management of adenoidal
hypertrophy in children

Kenny Dimitra, S.Ked

12711012
Medical Faculty
Islamic University of Indonesia
Introduction
 The adenoids are a single, pyramid-shaped aggregation of lymphoid tissue
in the nasopharynx which is present at birth.
 Lymphoid structure undergoes hypertrophy until about seven years of age,
at which point it begins to atrophy and continues to do so until it almost
invariably disappears in adulthood.
 adenoids can obstruct the nasopharyngeal airway, and cause nasal
obstruction, mouth breathing, rhinorrhoea, snoring and hyponasal voice.
Obstructive adenoids also cause cough, restless sleep, enuresis, daytime
sleepiness, morning headache, dry mouth, halitosis, swallowing difficulty
and craniofacial growth abnormality (adenoid facies).
 Mometasone has lower bioavailability, extensive first-pass metabolism and
a relatively higher binding affinity for the glucocorticoid receptor than
other intranasal corticosteroids.
Rumusan Masalah
 Role of mometasone furoate aqueous
nasal spray for management of adenoidal
hypertrophy in children

Pertanyaan Penelitian
 Apakah mometason furoat cair semprot
hidung dapat mengurangi gejala hipertrofi
adenoid pada anak – anak ?
Hipotesis
 Pemberian mometason furoat semprot
hidung dapat mengurangi gejala hipertrofi
adenoid pada anak – anak
Materials and Methods
Study Design Waktu dan Tempat

Prospective, randomised, November 2011 – Maret 2013

double-blind, interventional
placebo-controlled study Kalawati Saran Children’s
Hospital, New Delhi, India
exclusion criteria
- previous adenoidectomy
- use of intranasal topical or systemic steroids in the
previous year
- associated marked tonsillar hypertrophy
- anatomical deformity of the nose
- sinonasal disease such as nasal polyposis or inferior
turbinate hypertrophy
- craniofacial abnormalities such as cleft lip or cleft
palate
- genetic diseases such as Down syndrome
- acute upper respiratory infection within two weeks of
enrolling in the study
- any clinically significant metabolical, cardiovascular,
neurological, haematological, gastrointestinal,
cerebrovascular or respiratory disease
 Statistical analysis
statistical analyses were
performed using SPSS version
19.0
Symptoms and
nasopharyngoscopic grade
(quantitative data) were
compared between groups
using the Student’s t-test

The qualitative data, adenoidal-

nasopharyngeal (AN) ratio,
nasopharyngoscopic value and
𝑃 value < 0.05 was defined as
change in quality of life, were
statistically significant.
compared between groups
using the chisquare test and
Fisher’s exact test.
Result
Result
Result
Result
Result
Discussion
 Fluticasone, flunisolide, beclomethasone dan mometasone semprotan
hidung telah digunakan sebelumnya dalam pengobatan hipertrofi adenoid.
Peneliti memilih mometason furoat semprot hidung karena manfaat
menguntungkan.
 Pada penelitian terhitung anak - anak (laki - laki dan perempuan) berusia 2-
12 tahun, sebagai regreasi ukuran adenoid dengan usia. Usia rata - rata pada
hasil penelitian adalah 7,4 tahun. Sampel penelitian terdiri dari 78% laki -
laki dan 22% perempuan. Predileksi jenis kelamin tidak dapat di generalisasi
sebagai ukuran sampel.
Conclusion
 Penggunaan 6 bulan mometason semprot hidung
efektif dalam merawat anak - anak dengan gejala
obstrktif adenoid. Pengobatan selama 6 bulan
dengan saline semprot hidung juga mengurangi
skor gejala
 Namun tidak ada statistik yang signifikan dalam
penurunan ukuran adenoid yang diamati pada
pasien yang diperlakukan dengan salin semprot
hidung. Mometason semprot hidung
meningkatka kualitas hidup pasien
CRITICAL APPRAISAL
 Role of mometasone furoate aqueous
nasal spray for management of adenoidal
hypertrophy in children

Rajashree Bhargava & Aravinda Chakravarti

PICO
 Problem : Pasien dengan hipertrofi
adenoid
 Intervention : Pengobatan dengan
mometasone semprot hidung
 Comparison : Pengobatan dengan saline
semprot hidung
 Outcome : Pengobatan dengan
mometasone dapat mengurangi
hipertrofi adenoid
THANKYOU