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The following is a summary of “Impact of intranasal corticosteroids in a Prospective Cohort of Children with Sleep-disordered Breathing,” published in the March 2024 issue of Pediatrics by Sylvia et al.
Sleep-disordered breathing (SDB) is a prevalent issue among children and often prompts adenotonsillectomy, making it a significant concern in pediatric healthcare. This comprehensive observational cohort study conducted in a specialized outpatient clinic delves into the efficacy of intranasal steroids (INS) in mitigating symptoms and reducing the necessity for surgical intervention in pediatric SDB cases.
A thorough observational cohort analysis was performed on 568 children, aiming to evaluate the impact of INS employment on symptom alleviation and surgical outcomes using the OSA-5 questionnaire and clinical and surgical measures as assessment tools.
Initial evaluation revealed a mean OSA-5 score of 7.78, with symptoms persisting for a median duration of 9 months (ranging from 2 to 72 months). Notably, 51% of the cohort underwent a trial of INS, with a significant portion (56%) reporting symptomatic improvement. Following INS administration, the mean OSA-5 score significantly decreased from 8.2 to 5.5 (p < 0.0001). Moreover, individuals in the INS trial group exhibited a higher symptom burden, turbinate size, and prevalence of atopy compared to their non-trial counterparts. Importantly, the surgical intervention rate in the non-trial group was 56%, contrasting with the 38% rate observed in the INS trial group (p < 0.001). The analysis unveiled a positive correlation between symptom severity and the efficacy of INS, with baseline OSA-5 scores emerging as predictive indicators of surgical requirement. Additionally, neither age nor atopic status significantly influenced the response to INS therapy.
This study underscores the persistent nature of SDB symptoms in the pediatric population, highlighting the potential of INS in ameliorating symptoms in over half of the cases. Notably, the trial group that received INS exhibited a significantly lower surgical intervention rate than the non-trial group despite presenting with more severe symptoms and clinical signs. Importantly, age and atopic status did not influence the efficacy of INS therapy, emphasizing its potential as an effective treatment modality in pediatric SDB cases.
Source: sciencedirect.com/science/article/abs/pii/S0165587624000533