What is the recommended treatment for a 12-year-old female with nasal polyps (nasal growths) experiencing mouth breathing and snoring?

From the Guidelines

The recommended treatment for a 12-year-old female with nasal polyps causing mouth breathing and snoring typically begins with intranasal corticosteroids such as mometasone furoate (1 spray per nostril daily) 1. This approach is based on the most recent and highest quality evidence available, which suggests that intranasal corticosteroids are effective in improving symptoms and reducing nasal congestion in patients with nasal polyps 1. The use of mometasone furoate is specifically recommended due to its efficacy in treating nasal polyps, as indicated in the 2015 clinical practice guideline on allergic rhinitis 1. Key points to consider in the treatment plan include:

• Consistent use of intranasal corticosteroids for at least 4-6 weeks to evaluate effectiveness
• Possible use of a short course of oral steroids like prednisone (0.5-1 mg/kg/day for 5-7 days) to quickly reduce polyp size
• Saline nasal irrigation twice daily to clear mucus and improve medication delivery
• Referral to an ENT specialist for evaluation and possible endoscopic sinus surgery if symptoms persist despite medical therapy for 8-12 weeks
• Consideration of allergy testing, as allergies may contribute to polyp formation These treatments aim to reduce inflammation, shrink the polyps, and restore normal nasal breathing, which is crucial in growing children to prevent potential effects on facial development and dental alignment 1.

From the FDA Drug Label

CHILDREN 12 YEARS OF AGE AND OLDER Week 1 – use 2 sprays in each nostril once daily Week 2 through 6 months – use 1 or 2 sprays in each nostril once daily, as needed to treat your symptoms After 6 months of daily use – ask your doctor if you can keep using

The recommended treatment for a 12-year-old female with nasal polyps experiencing mouth breathing and snoring is to use fluticasone propionate (IN) nasal spray. The dosage is 2 sprays in each nostril once daily for the first week, and then 1 or 2 sprays in each nostril once daily as needed to treat symptoms for up to 6 months. After 6 months, she should consult her doctor to determine if continued use is necessary 2.

Key points:

• Use 2 sprays in each nostril once daily for the first week
• Use 1 or 2 sprays in each nostril once daily as needed after the first week
• Consult a doctor after 6 months of daily use to determine if continued use is necessary
• Fluticasone propionate (IN) nasal spray can help relieve symptoms of nasal polyps, including mouth breathing and snoring 2 2.

From the Research

Treatment Options for Nasal Polyps

• The primary treatment for nasal polyps involves the use of topical corticosteroids, which have been shown to reduce polyp size and improve symptoms such as nasal blockage and loss of smell 3.
• Fluticasone propionate nasal drops have been specifically formulated for the treatment of nasal polyposis and have been demonstrated to be effective in reducing polyp size and improving symptoms in adult patients 4, 5.
• The efficacy of fluticasone propionate nasal drops has been compared to nasal spray formulations, with twice daily nasal drop application showing the highest efficacy in increasing total nasal volume, decreasing nasal polyp size, and improving symptoms such as nasal blockage and loss of smell 6.

Reducing the Need for Surgery

• Treatment with fluticasone propionate nasal drops has been shown to reduce the need for sinus surgery in patients with severe nasal polyposis and chronic rhinosinusitis 7.
• A study found that 13 out of 27 patients treated with fluticasone propionate nasal drops no longer required functional endoscopic sinus surgery (FESS) after 12 weeks of treatment, compared to 6 out of 27 patients in the placebo group 7.

Symptoms and Treatment

• Mouth breathing and snoring can be symptoms of nasal polyps, and treatment with topical corticosteroids such as fluticasone propionate nasal drops may help to alleviate these symptoms by reducing polyp size and improving nasal breathing 4, 5.
• It is essential to consult a healthcare professional for proper diagnosis and treatment of nasal polyps, as they can recommend the most effective treatment options and monitor progress 3.