{"id":4265,"date":"2022-05-03T11:47:20","date_gmt":"2022-05-03T10:47:20","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/paediatricnasalcomplaintsbyage\/"},"modified":"2025-01-13T13:49:16","modified_gmt":"2025-01-13T13:49:16","slug":"paediatricnasalcomplaintsbyage","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/paediatrics\/paediatric-ent\/nose-sinus-paediatric\/paediatricnasalcomplaintsbyage\/","title":{"rendered":"Nasal Complaints by Age"},"content":{"rendered":"\n<p>\u200bComplaints about nasal symptoms are very common. Luckily, most of these are symptoms of normal childhood development. <\/p>\n\n\n\n<p>This summary is intended to give guidance to management of nasal complaints according to age group:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Neonates and infants<\/li>\n\n\n\n<li>Pre-school<\/li>\n\n\n\n<li>School-age<\/li>\n<\/ul>\n\n\n\n<p>Please see Primary Care Management for first line approaches.<\/p>\n\n\n\n<p><strong>C.M. &amp; G.T. 03-05-23<\/strong><\/p>\n\n\n\n<div class=\"wp-block-getwid-tabs\" data-active-tab=\"0\"><ul class=\"wp-block-getwid-tabs__nav-links\"><\/ul>\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Referral Guidelines<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p>Neonatal rhinitis<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Refer if struggling to feed and failure to thrive<\/li>\n<\/ul>\n\n\n\n<p><strong>Pre-school<\/strong><\/p>\n\n\n\n<p>Adenoids<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Refer if signs of significant Obstructive Sleep Apnoea (OSA) or Otitis Media Effusion (OME) with hearing loss and\/or recurrent infections (see other RefHelp pages)<\/li>\n<\/ul>\n\n\n\n<p><strong>School Age<\/strong><strong><\/strong><\/p>\n\n\n\n<p>Mostly allergic &#8211; medical management (see other RefHelp pages)<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Consider referring to medical team if failure of medical management<\/li>\n<\/ul>\n\n\n\n<p>Unilateral expanding lesion-refer urgently to ENT.<\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Primary Care Management<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p><strong>Neonates<\/strong><\/p>\n\n\n\n<p><strong>Neonatal rhinitis<\/strong> very common<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>reassure \u2013 benign, self-limiting<\/li>\n\n\n\n<li>saline \/ suction<\/li>\n\n\n\n<li>rarely topical steroids\/decongestants short course<\/li>\n<\/ul>\n\n\n\n<p>Refer if struggling to feed.<\/p>\n\n\n\n<p><strong>Pre-School (See Ref Help <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/adenoids\/\" data-type=\"URL\" data-id=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/adenoids\/\" target=\"_blank\" rel=\"noreferrer noopener\">Adenoids<\/a>)<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Allergy<\/strong><ul><li>Uncommon<\/li><\/ul>\n<ul class=\"wp-block-list\">\n<li>Treat medically if troublesome: Nasal salt water sprays\/rinses bilateral bd, oral antihistamine, nasal steroid spray<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Adenoids<\/strong><\/li>\n<\/ul>\n\n\n\n<p>Reassure:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>hypertrophy 1.5 &#8211; 5 yrs (physiological)<ul><li>snoring<\/li><\/ul><ul><li>rhinorrhoea<\/li><\/ul>\n<ul class=\"wp-block-list\">\n<li>hyponasal voice<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<p>Refer to ENT if chronic (&gt;3 months)<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>signs of significant OSA (please see relevant section)\n<ul class=\"wp-block-list\">\n<li>OME with hearing loss and\/or recurrent infections<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<p><strong>School Age<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Adenoids usually atrophied<\/li>\n\n\n\n<li><strong>Allergy<\/strong> common<\/li>\n\n\n\n<li>Chronic sinusitis rare<\/li>\n\n\n\n<li>Nasal polyps almost exclusively in children with cystic fibrosis &#8211; bilateral\n<ul class=\"wp-block-list\">\n<li>Refer to medical paediatrics<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li>Malignancy very rare-unilateral mass suspicious\n<ul class=\"wp-block-list\">\n<li>If unilateral mass (that is not a polyp or turbinate) refer ENT urgently<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<p><strong>Polyps v Turbinates<\/strong><\/p>\n\n\n\n<p>Polyps are insensate.<\/p>\n\n\n\n<p>Polyps are soft and mobile, turbinates have a bony core, so are not.<\/p>\n\n\n\n<p>Polyps have a translucent, gelatinous appearance, whilst turbinates are more pink in colour.<\/p>\n\n\n\n<p>Often an inferior turbinate, possibly enlarged due to rhinitis, can be mistaken for nasal polyposis.<\/p>\n\n\n\n<p>The vast majority of children referred to exclude a nasal polyp have normal nasal anatomy.<\/p>\n\n\n\n<p>Malignancy is very rare and usually has other, red flag symptoms, for example proptosis and diplopia, ulceration, bleeding and is usually unilateral.<\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Resources and Links<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p><\/p>\n\n\n<\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>&#8203;Complaints about nasal symptoms are very common. Luckily, most of these are symptoms of normal childhood development. This summary is intended to give guidance to management of nasal complaints according to age group: Please see Primary Care Management for first line approaches. C.M. &amp; G.T. 03-05-23<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":22473,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"categories":[175],"class_list":["post-4265","page","type-page","status-publish","hentry","category-nasal-complaints-by-age-paeds"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"NHS Lothian","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/nhs-lothian\/"},"rttpg_comment":0,"rttpg_category":" <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/entpaediatric\/nasal-complaints-by-age-paeds\/\" rel=\"tag\">Nasal Complaints by Age (Paeds)<\/a>","rttpg_excerpt":"&#8203;Complaints about nasal symptoms are very common. Luckily, most of these are symptoms of normal childhood development. This summary is intended to give guidance to management of nasal complaints according to age group: Please see Primary Care Management for first line approaches. C.M. &amp; G.T. 03-05-23","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4265","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=4265"}],"version-history":[{"count":8,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4265\/revisions"}],"predecessor-version":[{"id":22469,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4265\/revisions\/22469"}],"up":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/22473"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=4265"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=4265"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}