Children's Hospital Colorado

Nasal Obstruction

What is nasal obstruction?

Nasal obstruction occurs when something is blocking the nasal passages on either one or both sides of the nose.

What causes nasal obstruction in kids?

Nasal blockage has many causes. These include:

  • Swelling of the lining of the nose
  • Narrowness of the nasal cavity (the space behind the nose in the middle of the face) related to a birth deformity
  • A cyst in the tear ducts
  • Deviated septum (when the bone or cartilage in the middle of the nose is crooked and makes breathing hard)
  • Incomplete development of the nasal cavity
  • Enlarged adenoids (the tissue at the back of the nasal passage)
  • Nasal polyps (small growths in the nasal passage that can sometimes cause breathing problems)
  • Foreign bodies
  • Vascular malformation (which happens when veins don't form properly)
  • Tumors

Nasal obstruction in children

Nasal obstruction can occur in any age group, but certain causes are more common in children of certain ages.

Nasal obstruction in infants

Nasal obstruction in infants is most often caused by nasal tissue swelling, but may also result from blockage from bone narrowing, incomplete development of the nasal cavity or blockage by a tear duct cyst.

Nasal obstruction in toddlers

Toddlers are most likely to have nasal obstruction from nasal tissue swelling or adenoid (the tissue at the back of the nasal passage) enlargement.

Nasal obstruction in kids and teens

Adolescents are more likely to have obstruction from nasal tissue swelling likely related to allergies, adenoid enlargement, septal deviation (crooked middle nose bone or cartilage), inferior turbinate (which filters and moistens air) enlargement, nasal polyps (small growths in the nasal passage) and very rarely, tumors. Tumors are rare and will usually present with other signs and symptoms.

What are the signs and symptoms of nasal obstruction in kids?

Common symptoms of nasal obstruction in children include:

  • Difficulty breathing through the nose
  • A "nasal" voice
  • Noisy breathing
  • Poor sense of smell
  • Drainage from the nose
  • Snoring

The signs and symptoms of nasal obstruction are well-known by most people and usually temporary. Other symptoms such as nose bleeds, headaches, pain and bad odor can be helpful in understanding the underlying cause of nasal blockage, but are less common.

How is nasal obstruction diagnosed?

Our care team will use the appropriate test or combination of tests based on your child's symptoms and medical history. Common tactics for diagnosis include:

  • Physical examination of the nostrils: This is the first step in diagnosis of any nasal obstruction.
  • Flexible or rigid nasal endoscopy: This is a procedure sometimes performed in our clinic that allows our doctor to visualize the inner cavity of the nose from the front all the way to the back. This allows the doctor to better understand the cause of the nasal obstruction.
  • Lateral soft tissue neck X-ray: This X-ray specifically evaluates the size of the adenoids (glands in the roof of the mouth) and how much obstruction they may be causing in the back of the nose.
  • Maxillofacial CT scan: Essentially a face scan, this two-dimensional X-ray is particularly helpful in evaluating the bone structure for the presence of narrowing or incomplete development of the nasal cavity. We also use this technology to evaluate the sinuses and nasal polyps.
  • Maxillofacial MRI: This is a two-dimensional imaging study used to evaluate the soft tissue causes of nasal obstruction. This is usually used to evaluate vascular malformation (improperly forming veins) or tumors.

What to expect from nasal obstruction diagnosis

It takes about an hour for our pediatric specialists to evaluate your child's chronic nasal blockage. Here's what to expect during your appointment:

  • A medical assistant will check your child's vital signs.
  • Then a nurse will discuss your child's symptoms and medical history.
  • Your medical provider will evaluate your child next and determine what other tests are necessary.
  • A nasal endoscopy, if necessary, will likely take an additional 15 to 30 minutes.
  • If our care team requests a soft tissue neck X-ray, that will likely take place in our radiology department and then your care team will discuss the results with you in our clinic.
  • A CT scan or MRI is typically scheduled on another day, if necessary.

Nasal obstruction treatment for kids

Our pediatric specialist will provide treatment recommendations based on your child's age and the underlying causes of their nasal obstruction. Our care team members have completed extra training for nasal conditions in children and will help you determine the best treatment for your child.

Non-surgical nasal obstruction treatment

For less serious conditions, such as congestion and swelling, common treatments include:

  • Nasal wash to clear mucus that may result from obstruction
  • Intranasal corticosteroids (steroids typically sprayed in the nose) to decrease inflammation
  • Oral/intranasal antihistamines alone or with decongestants to decrease swelling
  • Anti-secretion agents to prevent over-secretion

Nasal obstruction surgery

Surgery is often the best option for more serious structural issues involving the structures of the nose and face. Our care teams choose surgical options based on the location and cause of the obstruction. Providers typically recommend surgery when other medical therapy isn't effective.

Surgical treatments include:

  • Removing foreign objects
  • Cauterization (a heated probe reduces size) or partial removal of turbinates, which warm and moisten air as it goes through the nose
  • Septoplasty surgery to straighten or reposition a deviated septum
  • Polypectomy to remove nasal polyps
  • Endoscopic sinus surgery to remove sinus blockage and treat chronic sinusitis
  • Adenoidectomy to remove enlarged adenoids, the tissue at the back of the nasal cavity
  • Rarely, our surgeons will remove cysts or tumors from the back of the nose

Why choose Children's Colorado for your child's nasal obstruction?

We are relentlessly dedicated to making children feel better. Our care team members, from imaging specialists to doctors, are trained specifically in children's nasal conditions.

We want to provide relief for your child – whether they are uncomfortable from temporary congestion or swelling or have a more serious issue with their nasal structure. Our team has experience treating both common and rare conditions in children. We understand the unique aspects of each age group of children and can provide them an accurate diagnosis and effective care plan.

We use equipment, such as an endoscope, that is specifically designed to be more accurate and comfortable for children. To minimize the risk of cumulative radiation exposure we also use the lowest possible levels of radiation for X-rays and CT scans.

We also partner with your family from diagnosis through treatment and help coordinate any follow-up care with our specialists or your primary doctor.

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