What are common causes of nasal obstruction in children?

Doctor's Answers 1

The common causes of nasal obstruction in children seen in my practice include:

  1. Rhinitis- This refers to inflammation of the nasal cavity and can be allergic (e.g due to common house dust mites, cat/dog fur, pollens and mold) or non-allergic (e.g. due to a change in weather, exposure to cigarette smoke or perfumes and hormonal changes). Common symptoms include blocked nose, runny nose, sneezing, itchy nose/eyes and postnasal drip. A suggestive clinical history and an allergy test can be performed to distinguish between allergic and non-allergic rhinitis. Treatment include allergen or trigger avoidance, nasal steroid sprays and antihistamines.
  2. Enlarged adenoids - Adenoids are clusters of immune tissues that is located at the back of the nose. They are part of the immune system but does not play a major role. Adenoids can continue to grow bigger in children between 2-6 years old and usually begin to shrink there after. If an enlarged adenoid causes problems such as a persistent blocked nose, snoring and obstructive sleep apnoea or recurrent infections in the nose and middle ear, it can be surgically removed.
  3. Infections of the adenoid and sinuses - This can be viral or bacterial and the affected child will often present with a blocked nose, coloured/thick nasal discharge, postnasal drip and cough. A viral infection (usually with the presence of fever too) typically resolves within 7-10 days (without any antibiotic treatment) while a bacterial infection often lasts longer and will require antibiotic treatment.

If your child has been suffering from persistent troublesome nasal blockage resulting in mouth breathing, he/she should see an ENT Specialist. Mouth breathing bypasses the humidification and filtration function of the nose and this may result in a dry mouth, bad breath, poorer dental hygiene, higher risk of teeth malocclusion, snoring and sleep apnoea as well as poor posture and abnormal facial morphology.

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