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

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• Picked for Otorhinolaryngology (top studies of the week, 4 October 2026): Intratonsillar steroid RCT, pediatric ENT intervention

Abstract

INTRODUCTION: 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. OBJECTIVE: 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. STUDY DESIGN: Prospective study (Randomized control trial). MATERIALS AND METHODS: 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. RESULTS: 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. CONCLUSION: Intratonsillar steroid injections effectively reduced the size of palatine tonsils compared with NSS injections. Repeated steroid injections were more effective than a single injection.

Abstract as published, via PubMed.