Nasal Obstruction in Children

What is paediatric nasal obstruction?

Paediatric nasal obstruction, a common issue in children, can stem from several causes including enlarged adenoids, allergies, infections like the common cold, and structural abnormalities such as a deviated septum. A blocked nose, can restrict a child’s ability to exercise and even play games comfortable as well as impact quality of sleep.

Annakan Navaratnam runs a dedicated clinic at Great Ormond Street for the assessment and management of children with nasal problems. He will undertake a thorough history from both the patient and parents as well as comprehensive examination to identify the cause of symptoms.

Frequently asked questions

There are several causes of this common paediatric condition:

  • Enlarged adenoids
  • Allergic rhinitis
  • Sinusitis
  • Foreign bodies in the nose
  • Deviated septum (though less common in children than adults)
  • Nasal polyps (rare in children)
  • Choanal atresia (congenital condition, rare)
  • Tumors (very rare)

Treatment varies based on the cause but may include saline nasal sprays to moisten nasal passages, nasal steroid sprays to reduce inflammation, and, in some cases, surgical intervention to remove obstructions, such as removing adenoid tissue, or correct structural problems. In the case of allergies, identifying and avoiding allergens is key, alongside possibly using antihistamines and nasal steroids to control symptoms.

Nasal steroids are considered safe for use in children because they are designed to work locally within the nasal passages, targeting inflammation directly at the source with minimal absorption into the body. This localised action ensures that the medication has a high degree of efficacy where it’s needed while maintaining a low risk of systemic side effects.

Performing nasal septal surgery in children carries the risk of potentially disrupting midfacial growth, a concern given the developmental importance of the nasal structure in overall facial development. However, the benefits of improving nasal breathing and alleviating chronic nasal obstruction can significantly enhance a child’s quality of life, including better sleep and improve exercise tolerance.

Therefore, a tailored approach to decision-making and surgery is required, taking into account the child’s specific condition, age, and growth patterns to balance the risks and benefits effectively, ensuring the best possible outcome for each individual child.

Mr Annakan Navaratnam


Mr Annakan Navaratnam

Annakan Navaratnam is Consultant Ear, Nose & Throat (ENT) Surgeon whose private practice is based at Harrow and One Welbeck Hospital in Central London and The Clementine Churchill Hospital in Harrow. In his NHS practice, he works at Royal National ENT Hospital, University College London Hospital (UCLH) and is an honorary consultant at Great Ormond Street Hospital.

He has a subspeciality interest in rhinology and facial plastic surgery with particular expertise in septorhinoplasty and nose reshaping surgery.

Annakan is excellently placed to manage general adult and paediatric ENT presentations and in particular is able to assess and treat complex problems related to the form and function of the nose. This includes endonasal (scarless) rhinoplasty, revision septorhinoplasty as well as advanced endoscopic sinus surgery.