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Nasal Obstruction in Children: What are the causes behind it?

Nasal obstruction in kids may be observed shortly after birth. Children usually breathe through their nose, but when there is an obstruction or blockage in the nose, breathing gets difficult and creates noisy breathing patterns.

When children have nasal obstruction they tend to use their mouth for breathing. However, mouth breathing can lead to changes in the facial skeleton and dental arches in children. It is important to identify the reasons behind mouth breathing and nasal obstruction.

The ENT Clinic is a modern pediatric and adult ENT practice that uses the latest techniques for the diagnosis and treatment of ENT disorders in Singapore. The otolaryngologists and the medical team at the ENT clinic practice evidence-based medicine and are competent in handling nasal obstruction in children. Conveniently located at Gleneagles Hospital and Mt. Elizabeth Novena Center, this ENT practice is in easy reach for anyone residing in Singapore.

What is a nasal obstruction in children?

Nasal obstruction is when there is a complete or partial blockage of the air passages of the nasal cavity. The nasal cavity includes the air passage starting from the nostrils to the back of the throat. Any obstruction to this passage can affect the level of breathing.

What symptoms can be observed during nasal obstruction?

In children, it can cause noisy breathing and difficulty in breathing. In infants, breathing difficulty can be noticed when they are breastfeeding. There could be snoring when sleeping and mouth breathing. A runny nose could be a common symptom.

Recurrent sinus infections are common when there is nasal obstruction.  Most parents may not notice mouth breathing in children and one way to understand if your child is mouth breathing is to observe if their mouth is always open.

Whom should I consult if my child has mouth breathing?

Your GP will refer the child to an otolaryngologist who specializes in managing the causes of nasal obstruction.

What are the causes of pediatric nasal obstruction?

There could be many different causes behind nasal obstruction in children. While some are caused due to congenital reasons, others could be acquired later in life. The age when noisy breathing was observed is another way to determine the cause. Listed below are some of the causes:

  • Deviated Nasal septum: The two passages of the nose are separated by the nasal septum. This septum is formed of cartilage in the front and bone at the back. At birth, children can be born with a deviated septum which leads to a block in the nose. An injury to the nose can lead to a deviated septum later in life. When the nasal tissue is severely twisted, it has to be corrected by a surgery called a septoplasty.
  • Nasal polyps: This is a growth of tissue causing nasal obstruction. Nasal polyps protrude from the sinus lining to the nasal passage. The ear, nose, and throat doctor will evaluate through a physical examination and X-rays to determine the extent of the polyp. Nasal polyps can lead to chronic irritation and infections.
  • Hematoma: When there is an injury to the nose, it may lead to the formation of a blood clot called a hematoma. This can obstruct the nasal passage. Children can injure themselves when they play about, and cause a hematoma to form. This should be treated immediately else there could be loss of support to the nose.
  • Tumors: Children may also develop tumors rarely. It could be malignant or benign tumors. Children with tumors can complain of stuffiness in one side of the nose. There could be drainage issues, bleeding, and swelling. For evaluation, ultrasound scans and X-rays may be done to diagnose the condition.
  • Choanal atresia: This is unilateral or bilateral in nature. This condition causes the back opening of the nose to be blocked with tissue or bone. If there is a complete block it will be noticed right after birth. Then surgery is needed to help the child with normal breathing. If there is only partial blockage, it may remain unnoticed for some time. Evaluation generally only happens when there is stuffiness of the nose, discharge, and sinusitis on one side.
  • Foreign body: Children at a young age when at play may place various foreign objects in the nose which can lead to obstruction. Such children can develop a foul-smelling discharge on one side of the nose. Removal can be done usually as an out clinic procedure, but if the foreign body has been lying for a long time then a small dose of anesthesia would be used for numbing to remove it painlessly.
  • Rhinitis: Allergies, irritants, and chemicals can cause inflammation of the lining of the nose. This makes the child breathe through the mouth. Infants may face considerable distress due to this condition and careful evaluation is needed by an ENT doctor. The doctor may ask for additional testing if required.
  • Adenoid hypertrophy: This is when the adenoids increase in size in children. It may be due to an infection. Some children when they get older experience a growth in their adenoids causing them to become larger and block the nasal passage. It causes snoring and mouth breathing. In addition, it may cause hypo-nasal sounds when breathing.

How is nasal obstruction diagnosed by an ear nose and throat specialist?

Depending on the age of the child and the prevailing symptoms, the ENT doctor will decide the best way to perform the diagnosis. A thorough physical examination is done and a nasal endoscopy may be suggested by the pediatric ENT physician if required.

To measure the nasal air inflow, a nasal patency test may be performed. Nasal patency is measured using the cross-sectional area of the nasal cavity. Obstruction may also be measured using imaging techniques such as CT scans and MRI scans.

The volume measurements would be done using rhinometry and rhinosterometry. X-rays are also useful to look into the nose and sinuses.

Once the diagnosis is done, appropriate treatment will be performed by the ENT doctor. The ENT Clinic Singapore caters to children of all ages and the medical staff is well trained to handle pediatric ENT conditions.

The clinic remains a leading choice for pediatric ENT consultation in Singapore.