Approach to paediatric nasal obstruction.

BACKGROUND

Paediatric patients with nasal obstruction are frequently encountered in general practice. The differential diagnosis is distinct from that of adult nasal obstruction and necessitates more judicious use of radiological and invasive investigations. Most cases of nasal obstruction in children result from benign disease, although there is a significant quality of life impact that must be addressed with prompt diagnosis and symptomatic management.

OBJECTIVE

The aim of this article is to outline the workup and management of paediatric nasal obstruction in primary care and suggest where referral to a relevant specialist is warranted.

DISCUSSION: Although the differential for paediatric nasal obstruction is broad, a thorough history and physical examination yields the diagnosis in most cases. Diagnoses not to be missed include nasal foreign body, lesions suspicious for neoplasia and intracranial complications of severe rhinosinusitis. Further investigation and ear, nose and throat referral should be considered when there are surgical targets for nasal obstruction, red flag signs or symptoms or failure of conservative therapy.