Inclusion criteria:
Children aged 6–12 years with a diagnosis of adenoid hypertrophy, confirmed by clinical symptoms and physical examination, nasal endoscopy, and lateral cephalometric radiography, who present to Amiralmomenin Educational and Medical Center in Rasht, will be enrolled in the study.
These children must have experienced at least one of the following clinical symptoms for a minimum of 3 months: chronic nasal obstruction, nocturnal snoring, mouth breathing, rhinorrhea, cough, or hyponasal speech.
The palatine tonsils must be normal in size or classified as Grade 1–2.
The children must not have an indication for tonsillectomy due to chronic tonsillar inflammation.
Exclusion criteria:
Children who have used systemic or topical corticosteroids, decongestants, or antihistamines within the previous 2 weeks
Children with a known hypersensitivity to fluticasone or azelastine.
Children with severe underlying medical conditions, such as uncontrolled asthma, cardiac or hepatic diseases, immunodeficiency disorders, craniofacial anomalies including cleft lip and palate, genetic disorders (such as Down syndrome), or neurological disorders.
Children with an active respiratory or sinus infection requiring antibiotic treatment, or those who use other antiallergic medications or corticosteroids during the study.
Children who do not adhere to the treatment protocol.
Children with Grade 3 or 4 palatine tonsils, a history of peritonsillar abscess occurring more than twice a year, or an upper respiratory tract infection within the previous 2 weeks.
Children with a history of previous adenoid surgery or tonsillectomy.