[Intranasal steroid therapy in inflammatory nasal-sinus pathology in pediatric age]

Nasal obstruction is the symptom par excellence signalling the onset of nasal-sinus inflammatory pathologies (allergic rhinitis, acute or intermittent rhinosinusitis without nasal polyps, persistent rhinosinusitis without nasal polyps, chronic or intermittent rhinosinusitis associated with nasal-sinus polyposis). This symptom is due, in particular, to the host's response to the etiological factor for which, where there is no accompanying infectious process, the therapy should be aimed at resolving the inflammatory response. The anti-inflammatory properties of steroid drugs have been used systemically with excellent results. Unfortunately, prolonged use can foster the onset of major side-effects. Hence, the need to create new pharmacological molecules with topical action, while maintaining the characteristics of systemically used steroids. Up to the present, many intranasal steroids have been examined with positive results in inflammatory nasal-sinus pathologies. It should be noted that systemic bioavailability after intranasal therapy with mometasone furoate (MF) is lowest with respect to other steroid molecules. In recent decades topical intranasal steroids have also been tested in adenoid hypertrophy, a typical infant condition, with encouraging results. For this reason, the authors have assessed the effectiveness of MF on the reduction of the adenoid mass and, consequently, on the improvement in obstructive nasal symptoms in the short term and after a long-term follow-up, obtaining positive results. To conclude, intranasal steroid drugs are certainly useful in the treatment of nasal-sinus inflammatory pathologies. Furthermore, our studies have shown that MF can improve the clinical picture of adenoid hypertrophy.