Background: Nasal obstruction is a frequently encountered problem in the pediatric age group obstructs the nasopharyngeal airway and Eustachian tube orifice resulting in a conductive hearing loss. Topical nasal corticosteroid spray reduced adenoid size and improved symptoms of nasal airway obstruction and obstructive sleep apnea.
Aim of the study: To evaluate the efficacy of Mometasone furoate aqueous nasal spray in management of adenoidal hypertrophy in children.
Methodology/Principal: A double randomized clinical trial was performed on 168 adenoid hypertrophy patients divided randomly into two equal groups: study group (received Mometasone furoate aqueous nasal spray for 6 weeks) and control group (received nasal normal saline drops for the same period). 
Results: The study group patients show significant improvement in nasal obstruction from 60.7% to 27.4% after treatment , mouth breathing from 84.2% to 25%, snoring from 72.6% to 31% and nasal discharge from 64.2% to 22.6%. Conclusion: Intranasal Mometasone furoate aqueous nasal spray may obtain some successful results in some cases of adenoid hypertrophy to improve nasal obstruction symptoms and may be associated with a reduction in adenoid size.
Keywords: Corticosteroids; Obstruction; Adenoid; Mometasone; Randomized controlled trial.