Congestion and Stuffy Nose in Children

Congestion and Stuffy Nose in Children / "Deniz Enöz" and "Işıl Enöz"

Nasal obstruction is a condition that may accompany different diseases and conditions and sometimes cause serious health problems. Babies, especially because they are dependent on nasal respiration, can be affected more severely in case of nasal congestion.

Functions of The Nose

- Smelling
- Filtering the breathing air (the air taken by the nose enters the turbulence and hits the nose and most of the particles and microorganisms are contained)
- Humidification of inhaled air
- Heating of inhaled air
- Increasing the pressure of the breathing air and delivering the lungs to the end airways.

Causes of Nasal Congestion and Stuffiness in Children

- Allergic diseases
- Upper respiratory tract infections
- Foreign bodies in the nose
- Genetic meat growth
- Nose growth
- Curvature of the nasal septum (nasal septum deviation)
- Choanal atresia
- Nasal valve problems
- Intranasal tumor masses
- Nasal polyps
- Nasal growth and mucosal thickening due to the drug using

sometimes in children and infants

- gastroesophageal reflux
- milk allergy
- Mother's story of syphilis
- congenital intranasal masses (esefalaocele, glioma, dermoid cyst) may also cause nasal congestion

Diagnosis of Nasal Obstruction Causes and Different Symptoms

Diseases and conditions that cause nasal obstruction have some specific signs and symptoms. These can be summarized below:

Nasal obstruction due to allergic rhinitis

Allergic diseases, in addition to nasal congestion, usually runny nose, nasal discharge, sneezing, and sometimes there are symptoms such as cough. Generally, these symptoms last longer than nasal discharge and nasal discharge seen in upper respiratory tract infections. The patient does not have fever weakness, which is the symptoms of infection.

Nasal congestion due to upper respiratory tract infections

Patients usually have signs of infection (malaise, body malaise, muscle joint pain and fever). The absence of fever and the presence of symptoms such as runny nose, sneezing suggest viral infection.

Nasal congestion due to choanal atresia

The areas of the nostril opening to the nasal area are called "choana". It is called "choanal atresia" because these congenital regions are covered with bone and mucosa (sometimes only a thin membrane). When the baby is born, it can cause serious breathing difficulties. Genital, urinary and cardiac anomalies may be present. When it is unilateral, sometimes the diagnosis may be delayed. The diagnosis of koanal atresia is supported by the inability to advance the probe to the nose of the newborn; The nose is placed by endoscopic examination and computed tomography. In babies with choanal atresia, it is typical to be crying and having relief when the bottle is cut.

Nasal congestion due to nasal polyps

Nasal polyps are rare in infants. Children with polyps in the nose may have different diseases such as ciliary dyskinesia, Churg-Strauss Syndrome, diffuse variable immunodeficiency, and selective IgA deficiency.

Nasal congestion due to foreign object in the nose

Babies, while exploring their bodies, can insert different foreign bodies into their nostrils. Children with foreign bodies in the nose may have a recurrent inflammation of the nose through the nostril. The unilateral flow and uninterrupted flow are typical features.

Nasal Congestion Treatment

Congestion and Stuffy Nose in Children / "Deniz Enöz"

Nasal obstruction may be due to one or more reasons listed above. Causes and diseases should be treated. A simple otolaryngological examination and endoscopic examination are usually sufficient to reveal each cause. MRI or Computed Tomography may be required. It is inconvenient to use some of the drugs used to treat nasal congestion in infants. Similarly, in children under 18 years of age, nasal septum deviation (septoplasty) can be performed to treat nasal obstruction.

Treatment of nasal obstruction in children and infants

It is recommended not to use flu medications, some allergy syrups in children under 2 years of age. In addition, intranasal cortisone sprays used in allergic nose growth are also inconvenient for children under 2 years of age. The most appropriate application for nasal congestion in infants is the application of salt water to the nose, as well as the treatment of diseases that can cause nasal obstruction, such as allergic disease, infectious diseases. Even in the case of influenza infections, the trickle of salt water into the nose, the treatment of ocean water spray and healing of nasal congestion is useful.

Why is nasal obstruction in the infants easily revealed?

Infants' airways differ from adults. Infants who are dependent on nasal respiration have narrower airways and lower respiratory capacity than adults. In infants, a small amount of intranasal discharge or mucosal edema may cause severe nasal obstruction. Therefore, nasal congestion in infants is more easily revealed.

Children are more dependent on the nasal breathing!

​At the child airway, nasal breathing is essential, especially when the nasal congestion in small babies can develop severe respiratory distress. Serious respiratory distress may occur in infants due to dry secretions in the nose even if there is no serious disease in the middle. Especially in children under 2 years of nasal congestion occurs, instead of medical treatment; it is recommended to irrigate only the nose with natural salt water. The prevalence of upper respiratory tract infection is higher in children between the ages of 2 and 6 years and this is the most common cause of nasal obstruction due to secretion of the mucous membranes due to upper respiratory tract infections.

​If your child is complaining of nasal congestion and nasal discharge, pay attention to the color of the nasal discharge

In children, when there is a runny nose with nasal congestion, the color of the runny nose may change depending on the cause as the below:
  • dark purulent discharge may be a sinusitis symptom
  • serous secretion with eye itching and sneezing may be a symptom of allergic rhinitis 
  • transparent nasal discharge with muscle joint pain and weakness is a sign of viral upper respiratory tract infection 
  • unilateral and smelly nasal discharge may be a sign of foreign body in the nose.
Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon - ENT Doctor in Istanbul

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