Could a nasal spray reduce the number of tonsillectomies in children?

Could a nasal spray reduce the number of tonsillectomies in children
Could a nasal spray reduce the number of tonsillectomies in children Photo: SHUTTERSTOCK

Could a simple nasal spray reduce the number of child tonsillectomies?

​That's what researchers at Murdoch Children's Research Institute (MCRI), the largest child health research institute in Australia, are hoping to find out as they embark on a trial study.

The aim of the trial will be to assess whether an anti-inflammatory nasal spray could assist children who snore or have breathing difficulties while sleeping. About 10 percent of children who suffer from snoring have some sort of obstructive sleep apnoea, a sleep disorder that leads to pauses in breathing throughout the night.

Currently, the most common treatment for snoring is to surgically remove the adenoids and tonsils. There are over 40,000 tonsillectomies conducted per year - the most common elective childhood operation in Australia 

"Surgery is a big deal for any child," said lead researcher Dr Kirsten Perrett. "It requires an anesthetic, can be very painful and there are risks of bleeding." And long waitlists can also be a problem.

Associate Professor Gillian Nixon, who will oversee the trial at Monash Children's Hospital, says the over the counter spray, which is already used to treat children with hay fever,  needs to be used for six weeks.

"We are optimistic that this nasal spray may be a simple, safe alternative to surgery in many children to treat this common childhood problem," she said.

The pair are now recruiting participants for the study and are seeking around 300 children aged three to 12 years.

"We are accepting children into the trial who have been referred for snoring to either the Royal Children's Hospital, Monash Children's Hospital or the Royal Victorian Eye and Ear Hospital," Associate Professor Nixon says.

Families will need to attend two visits to either Monash Health or the Royal Children's hospital six weeks apart and complete four surveys over the next two years. Children will be given either the nose spray or a placebo (saline) each day for six weeks.

Last year, a study found that seven in eight children who have their tonsils removed do not benefit at all. "Tonsillectomy is marginally beneficial in severely affected children who have frequent sore throats, documented in medical records and with specific symptoms," the authors wrote at the time, comparing the procedure to blood letting.

But what about tonsillectomy for sleep-related breathing problems? "A review of the evidence was unconvinced of the case for tonsillectomy," they wrote.

If you are interested in being part of MIST trial you can register online here.