Investigating the frequency of adenoid hypertrophy and allergic rhinitis in children with mouth breathing complaints

Background and Objectives: Nocturnal snoring and open mouth breathing in children is one of the common causes of referrals to pediatricians. The two most common reasons of this problem are adenotonsillar hypertrophy and allergic rhinitis. Based on the findings, there is still no significant relationship between these two diseases. Therefore, the aim of this study was to determine the frequency of adenoid hypertrophy and allergic rhinitis in children with mouth breathing complaints who referred to the allergy or ENT clinic of Ali Asghar Hospital in Tehran during 2015-2016. Methods: The population included all children between the ages of 4 and 12 years with symptoms of mouth breathing and nocturnal snoring referred to Allergy clinic of Ali Asghar Hospital during 2015-2016. These patients were examined by allergy sub-specialist in terms of atopy, allergic rhinitis, and allergy tests history. Patients were also examined by hospital otolaryngologist and otolaryngologist and the severity of tonsil hypertrophy and conchae was found. A checklist of the patient gender and age, age of the first allergic rhinitis symptoms, clinical signs at referral time, the severity and frequency of allergic rhinitis symptoms, other diseases, selected therapies by doctor, is also completed by researcher. Allergic rhinitis symptoms and adenoid hypertrophy symptoms and severity of asthma, duration of allergic rhinitis symptoms, quality of life, parent's history of smoking in children, and parent's history of snoring were also included in.   Results: 104 children at mean age of 6.35 ± 2.65 years were enrolled. Of these, 54.8% were male. Only 17.3% of children had adenoid hypertrophy, and other children had seasonal or perennial allergic rhinitis, or had both of them.  The highest prevalence of nasal congestion symptoms was 92.3% and rhinorrhea was 79.8%. Mite allergy was 28.8%, weeds mixtures allergy 26.0%, pollen trees allergy 15.4%, dog and cat's hair allergy in 8.7%, and food allergies in 2.9% of children. The frequency of rhinorrhea, nasal congestion, sneezing, nasal itching, tearing and itching eyes, pulmonary allergy, asthma, gastro esophageal reflux and mites, weeds mixtures, pollen trees, dogs and cats hair allergies  was significantly more (p<0.05) in children with allergic rhinitis. However, the frequency of otitis media in children with adenoid hypertrophy was significantly higher than in children with allergic rhinitis (p<0.05). Conclusion: It can be concluded that the prevalence of allergic rhinitis which responds to avoidance of specific allergen and intranasal corticosteroid in children who referred with mouth breathing complaints is much higher than adenoid hypertrophy with no response to pharmacological therapy, and in case of proper diagnosis and treatment, a few children will ultimately require surgery. Therefore, considering the appropriate strategies and planning for early diagnosis and treatment of these patients, can reduce the need for surgery, its complications for patients.