Efficacy of Intratonsillar Steroid Injection for Reducing Palatine Tonsil Size in Tonsillar Hypertrophy: A Randomized Controlled Trial

Abstract

Tonsillectomy is a common treatment for obstructive sleep apnea (OSA) and remains one of the most frequently performed surgical procedures worldwide. However, postoperative morbidity is a persistent clinical concern. Intratonsillar steroid injection may offer a non-surgical alternative by reducing the size of hypertrophic palatine tonsils.

this study aims to evaluate the efficacy and safety of intratonsillar steroid injections compared to intralesional injections of normal saline solution (NSS) in tonsillar hypertrophy.

Prospective study (Randomized control trial)

In this randomized controlled trial, 19 participants (38 tonsils) were assigned to four groups receiving intratonsillar injections of triamcinolone acetonide (TA, 40 mg/mL, 1 mL) or NSS (1 mL). Nine participants received multiple injections at weeks 0, 4, and 8; ten received a single injection. Tonsil size was measured before each injection to assess the clinical efficacy of reducing palatine tonsil size.

There was a significant reduction in tonsil size after steroid injections, with a statistically significant difference observed only in the multiple steroid injection group (p-value = 0.04). The steroid injection group experienced slightly more pain compared to the NSS injection group, however, no severe adverse effects were observed in either group.

Intratonsillar steroid injections effectively reduced the size of palatine tonsils compared with NSS injections. Repeated steroid injections were more effective than a single injection.