Nasal airway obstruction in children (兒童鼻氣道阻塞)

Nasal obstruction in children is usually noted by parents,, particularly when accompanied by rhinorrhea and snoring. Adenoid hypertrophy is the common cause of pediatric nasal obstruction. However, the following conditions should also be borne in mind.

Posterior choanal atresia (後鼻孔閉鎖)

Aetiology:

A congenital condition caused by persistence of the embryonic bucconasal membrane. The obstruction is at the posterior end of the nose near the edge of the hard palate.

Clinical features:

In bilateral cases there is respiratory difficulty at birth aggravated by feeding and necessitating the use of an oral airway. Unilateral cases present later with unilateral nasal obstruction and rhinorrhea. Diagnosis is made by the inability to pass a rubber catheter through the nose into the pharynx and is confirmed by CT scanning.

Management:

Surgical division of the atretic plate by the transnasal or transpalatal route is required.

Nasal foreign body (鼻腔異物)

A common occurrence in children, e.g. with beads, pieces of sponge or paper.

Clinical features:

Typically presents with unilateral foul blood-stained rhinorrhea, nasal vestibulitis and fetor.

Management:

A general anesthetic is occasionally required for removal in an uncooperative child.