الفهرس 
Anatomy and physiology of nasopharyngeal tonsilOnly 14 pages are availabe for public view
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Abstract
The adenoid is one of the important parts of the Waldeyer’s ring that is located in the nasopharyngeal area. Adenoid hypertrophy (AH) is detected in most of general pediatric population and constitutes one of the most frequent otorhinolaryngological indications for surgical intervention.
Adenoid hypertrophy causes mouth breathing, nasal congestion, hyponasal speech, snoring, rhinorrhea, postnasal drip, cough, dry mouth, halitosis, swallowing difficulty, obstructive sleep apnea (OSA), chronic sinusitis and recurrent otitis media.
Adenoidectomy is the definitive worldwide used method for treatment of adenoid hypertrophy, this surgery has some complications like; hemorrhage, infections and palate dysfunction besides the risks of general anesthesia.
Medical treatment for adenoid hypertrophy using anti- inflammatory and anti-allergy medications has gained importance in the last few years because of its low prevalence of complications and general good results.
Intra nasal corticosteroid spray decrease adenoid pad volume and improve symptoms of AH by several mechanisms, such as direct lymphocytic action and inhibition of inflammation.
The aim of this work was to compare between the effectiveness of intranasal corticosteroid vs intranasal corticosteroid and systemic corticosteroid in the treatment of adenoid hypertrophy in children In our study, we included 30 patients in each group; the studied groups were matched in age and sex. We assessed patients in our study using both subjective and objective measures. Patients assigned to groups randomly with no significant differences at the initial assessment as regards main symptoms scores, A/N ratio and adenoid hypertrophy grades.
After 6 weeks of treatment, based on the subjective assessment, we compared the scores of main symptoms; rhinorrhea, mouth breathing and snoring between both groups. There were better scores in group 2 (combined therapy) with statistically nonsignificant differences.
Based on the objective assessment, we compared the adenoid hypertrophy grading by endoscopic examination after 6weeks of treatment. This shows a significant improvement in both groups but with superiority in group 2 (combined therapy)