Compared to the year before the procedure, at 1-year postadenotonsillectomy follow-up, there was a % reduction in acute asthma exacerbations and a % reduction in acute status asthmaticus ( P < for both). [ 68 , 69 ] In addition, asthma-related emergency department visits were reduced by % and asthma-related hospitalizations by %. Patients who underwent the procedure also had significantly fewer refills of several asthma medications. In contrast, no significant reductions were observed in any of these outcomes among children who did not undergo adenotonsillectomy. [ 68 , 69 ]
The growth of children and adolescents receiving orally inhaled corticosteroids, including QVAR, should be monitored routinely (., via stadiometry). If a child or adolescent on any corticosteroid appears to have growth suppression, the possibility that he/she is particularly sensitive to this effect should be considered. The potential growth effects of prolonged treatment should be weighed against clinical benefits obtained and the risks associated with alternative therapies. To minimize the systemic effects of orally inhaled corticosteroids, including QVAR, each patient should be titrated to his/her lowest effective dose [see Dosage and Administration ( )] .