On the Coast – Families Issue 102 I October/November 2019 | Page 36

‘N’ is for Nose
BY DR SAMANTHA PETHEN
I
n the second of my three articles on
ENT issues affecting children, I will
tackle ‘N’… which stands for Nose!
GPs see many issues affecting the nasal
passages, ranging from snuffly babies,
to allergic rhinitis, to sinusitis. These
are pretty common, can have serious
consequences if not dealt with, but are
fortunately, generally easy to treat!
The nasal passages are very technical
tubes! Their function is to warm, moisten
and filter the air that we breath. They
are also designed to be the first point of
detection of infections, and can mount
a response directly to an attack! A lot of
issues are more common in children as
their tubes are smaller than an adults
and their adenoids and tonsils are
relatively larger.
One example of this is ‘the snuffles’,
which is common in babies. If the baby is
otherwise well, happy and feeding, no
treatment is needed. It’s common for
normal mucus to just sit in their noses, as
they have not yet learnt to sniff, or blow it
out! Having a nasal discharge (clear or
coloured) doesn’t always mean an
infection, and we like to keep an eye on
other measures of wellbeing, for instance,
their interest and ability to feed, the
presence of a fever and if they are content
and engaging or miserable and crying.
If the baby is starting to get more
snuffly during feeds, there are some
simple measures that may help. A bowl
of water in the baby’s room will raise
the humidity of the air and help loosen
thick mucus. If your baby has a blocked
nose when a feed is due, saline drops
can help. Care is needed with these, as
if they are used too much, the skin can
become irritated. Nasal aspirators help to
suck mucus from your baby’s nose, some
parents love them, and the research
available suggest they do no harm.
If an infection does try and enter our
nasal passages, hopefully the adenoids
will leap into action! Adenoids are lymph
nodes that sit behind the nose, they are
like the lymph nodes under our arms
and in our neck. Their job is as a first
line of defence and can become enlarged
when we are fighting infections. If
this happens, they can cause mouth
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O N T H E C OA S T – FA M ILIES
breathing, a nasal quality to the voice,
yellow or green mucus, snoring and
obstructive sleep apnoea. Adenoids grow
most rapidly between 2 and 7 years old.
If they grow too large, or are inflamed,
they can contribute to recurrent ear
infections, glue ear, hearing and speech
issues (see my recent article on ears!),
sinus infections, snoring or sleep apnoea
(you’ll have to wait for my next article to
read more about this!).
Adenoids and the nasal passages can
also become enlarged due to allergies to
inhaled particles, for example pollen,
perfumes, house dust mite and fur (this is
also called allergic rhinitis). If we can
identify the cause of this, we can try and
reduce the child’s exposure to it.
Treatments can include antihistamines
and steroid nasal sprays, sometimes it
take a little persistence to work out the
treatment that is best for your child. If
these fail, adenoids can be removed
surgically.
If a child develops sinusitis, this means
that one of the hollow cavities in the
skull has become inflamed and possibly
infected. There are four pairs of sinuses
in the face, and they are lined with the
same membrane that is found inside the
mouth and nose. Their main function
is to warm and moisten and filter air.
An infection in the sinuses commonly
happens after a cold, or an allergic
episode (for example during hayfever
season, or after spring cleaning!)
Sinusitis causes a stuffy/runny nose, it
can cause bad breath, ear pain, dental
pain or facial tenderness, among other
symptoms. If your child has had a cold
that has lasted for more than 7-10 days,
or a cold getting worse after 7 days, or
allergy symptoms that aren’t getting
better with their usual treatment, these
could all be signs they should see a doctor.
In summary –
ƒ ƒ The nasal passages are sensitive,
complicated and very important
ƒ ƒ A lot of symptoms will settle with no
intervention
ƒ ƒ Adenoids are lymph nodes that sit at
the back of the nose and may become
enlarged in response to infection or
allergies
ƒ ƒ Enlarged adenoids can cause snoring,
sinus infections, ear infections and
glue ear
ƒ ƒ If this causes recurrent episodes, an
operation may be advised to remove
them
ƒ ƒ As ever, if you are worried your child
is unwell, or not getting better, you
must take them for review by a doctor
Dr Pethen is a GP at your Family Doctors at Erina, a doctors surgery that aims to deliver high quality
care with a personal touch, find them at www.yourfamilydovtors.com.au or phone [phone]