Have you considered these 7 causes?
When a child has a stuffy nose, the first thing most parents think of is a cold or rhinitis. But in fact, most colds can recover within 7~10 days. If the cold is treated for about 10 days, it still does not get better or the rhinitis treatment has no obvious effect. Should we consider other factors?
There are many reasons for nasal congestion. Let’s take a look at the common causes of nasal congestion.
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8znasal foreign body
I believe that many parents have seen popular science articles about foreign bodies in the trachea, and have also learned about the Heimlich first aid method. They rarely heard about foreign bodies in the nasal cavity.
Don’t forget, children are naturally curious. Not only do they want to taste weird things, but they also like to explore unknown areas, such as stuffing their noses or ears.
nasal foreign body characteristics:
nasal foreign bodies are mostly found in children aged 1 to 6 years old, who may self-report a history of foreign body intrusion.
Nasal congestion caused by foreign bodies in the nasal cavity is mostly unilateral. Statistics have found that foreign bodies on the right side are common, possibly because the number of right-handed children accounts for the vast majority of children.
In addition to nasal congestion, nasal odor and/or pus, bloody discharge, etc. may also occur. The location of the
foreign body is different, and the removal method is different: foreign body is located between the back of the nasal vestibule and the anterior lower part of the nasal cavity. It can be removed with simple equipment in the outpatient and emergency department; it is located in the middle and back of the nasal cavity and needs to be removed under general anesthesia.
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adenoid hypertrophy
adenoids are immune organs located behind the nasal cavity. Repeated respiratory infections can easily stimulate the adenoids and cause hypertrophy, which can block the posterior nostrils and block the airway and cause nasal congestion. The typical feature of
is snoring after falling asleep.
In addition, because the child's breathing is affected, he is forced to breathe through his mouth. For a long time, it affects the development of the child's facial bones, and a "proliferative body/adenoid face" appears. It is characterized by high arched zygomatic arches, protruding incisors, uneven dentition, upturned upper lip, sluggish facial expressions, and listlessness. When the enlarged adenoids press against the opening of the adjacent Eustachian tube, otitis media can also occur, affecting hearing.
Electronic nasopharyngoscope can directly observe the size of adenoids in children with disease and assess the proportion of nostrils after adenoid obstruction. It is often used as the "gold standard" for the diagnosis of adenoid hypertrophy in clinical practice.
has no radiation due to nasopharyngoscopy, which is easier for parents to accept than lateral nasopharyngeal radiographs.
currently recommended drug treatment is mostly: nasal glucocorticoids are mostly 6 weeks, and the treatment cycle of leukotriene receptor antagonists is 8-12 weeks. After taking montelukast and nasal hormones for about 2 weeks, the symptoms of nasal congestion can be significantly improved.
is ineffective after conservative treatment, and the child with obvious hypoxia symptoms requires surgical treatment.
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8zNasal polyps
Nasal polyps are neoplastics on the nasal cavity or sinus mucosa protruding from the surface of the nasal cavity mucosa. Characteristics of
nasal polyps:
nasal polyps are more frequent on both sides, but less on one side. A common symptom is persistent nasal congestion, which worsens as the polyp grows in size.
Increased nasal secretions are accompanied by sneezing, such as sinus infections, the secretions may be purulent.
have olfactory disorders. People with severe nasal congestion have obstructive nasal sounds and snoring during sleep.
If polyps block the opening of the Eustachian tube, it can cause tinnitus and hearing loss. The
polyps block the sinus drainage and can cause sinusitis. The patient has pain and discomfort in the back of the nose, forehead and cheeks.
Rhinoscopy can confirm the diagnosis.
Small polyps can be treated with medication to control their growth. Functional endoscopic nasal cavity and sinus surgery was performed for those who failed to drug treatment.
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Deflection of the nasal septum
Previously, the author also felt that the deflection of the nasal septum was caused by congenital developmental abnormalities, but recently I checked the data and found that many reasons can cause the deflection of the nasal septum:
trauma;
often coexists with the high arch palatine arch. It is caused by adenoid hypertrophy and mouth breathing; turbinate hypertrophy or tumor compression on the side of
nasal cavity;
genetic factors.
The nasal congestion with deviated nasal septum is mainly due to the wide nasal cavity on the opposite side. Over time, the compensatory hypertrophy or hyperplasia of the mucosa and turbinate causes the nasal cavity to shrink due to physiological compensation. At the same time with mouth breathing, throat discomfort or foreign body sensation, Or snoring after falling asleep.
This disease is mainly used to treat the primary disease, and at the same time surgical plastic surgery.
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8zSinusitis
Acute sinusitis: refers to acute inflammation of the nasal cavity and sinus mucosa after bacterial infection. The nasal symptoms persist for more than 10 days and are completely relieved within 12 weeks.
Chronic sinusitis: nasal symptoms persist for more than 12 weeks, and the symptoms cannot be completely relieved or even worsened.
main symptoms: nasal congestion (open mouth breathing, thick breath or snoring during night sleep), runny nose, cough, headache.
Accompanying symptoms: dysosmia, hearing loss, abnormal behavior (inattention, irritability, irritability, etc.).
main signs: inferior turbinate congestion and swelling, nasal cavity, middle nasal passages have sticky (purulent) secretions, posterior pharyngeal wall lymphatic tissue hyperplasia, and visible sticky (purulent) secretions attached.
Accompanying signs: adenoids and (or) tonsillar hyperplasia and hypertrophy, some patients show signs of secretory otitis media. Z1z
can be diagnosed by rhinoscopy or sinus CT.
Most rhinosinusitis is treated conservatively with oral medications, unless one of the following conditions is required, surgery is required:
adenoid hypertrophy and/or tonsil hypertrophy affecting nasal ventilation and drainage;
nasal polyps and/or postmaxillary sinus polyps It causes obstruction to the drainage of the sinus-mouth-nasal complex;
has complications such as intracranial, intraorbital or periorbital complications.
drug treatments include: antibiotics, mucus promoting agents, reducing mucosal congestion, nasal corticosteroids, and nasal irrigation.
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allergic rhinitis
allergic rhinitis nasal congestion is mainly caused by inflammation of the nasal mucosa. In addition, is also accompanied by clear nose, sneezing, and it is more obvious when encountering cold air or pollen and other allergens. During the onset of
, pale edema of the nasal mucosa can be seen.
glucocorticoids are the most effective drugs, followed by anti-leukotrienes, and third is antihistamines. Nasal decongestants can be considered for rapid relief of nasal congestion in the short term, but it should not exceed 7 days.
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infectious mononucleosis
This disease is caused by Epstein-Barr virus infection. The main manifestations are fever, angina, skin rash, lymphadenopathy, followed by nasal congestion, eyelid swelling, splenomegaly, and liver enlargement.
Peripheral blood leukocytosis and lymphocyte increase, which can be used as one of the criteria for preliminary screening. Among them, an increase in atypical lymphocytes, accounting for more than 10% or more than 1×10^9, can be used as an indicator of clinical diagnosis.
Anti-EBV-CA-IgM and anti-EBV-CA-IgG antibody positive, anti-EBV-NA-IgG negative or anti-EBV-CA-IgM negative, anti-EBV-CA-IgG antibody low affinity positive one of two Diagnosed as childhood infectious mononucleosis.
This disease is mainly antiviral symptomatic and supportive treatment.
In addition, congenital posterior nostril atresia, granulomas, and ciliary dyskinesia may also have nasal congestion. Therefore, if conventional treatment fails, you must take your child to see a doctor in time to avoid delaying the condition.
References:
[1] Chen Guowei, Yan Shang, Pan Hongguang, etc. Clinical manifestations, diagnosis and treatment of nasal foreign bodies in children[J]. Chinese Medicine, 2019, Volume 14(7):1082-1085.
[2] Qian Nannan, Wang Wenzhong. Research progress of montelukast and nasal glucocorticoids in the treatment of pediatric adenoid hypertrophy[J]. Anhui Medicine, 2017, Volume 21(3):435-438.
[3]李 Xianlong, Wen Xiangling.The evolution and current status of the treatment of deviated nasal septum[J].Journal of Clinical Otorhinolaryngology,2004(11):701-704.
[4]Recommendations on the diagnosis and treatment of rhinosinusitis in children (2012, Kunming)[J ].Chinese Journal of Otorhinolaryngology Head and Neck Surgery,2013(03):177-179.
[5]Zhou Bing,Xu Geng.Mechanism and treatment of allergic rhinitis and nasal congestion[J].Journal of Clinical Otorhinolaryngology Head and Neck Surgery,2019, 33(08):780-785.
[6] Yin Jing. Infectious mononucleosis in childrenClinical treatment progress [J] Chinese prescription drugs, 2019,17 (06):. 32-34.
This article first appeared: the pediatric medical community channel
author: Medical white
Editor: Li Xiaorong
