Etiology and Management of Pediatric Nasal Obstruction: A Descriptive Cross-Sectional Hospital-Based Study

Abstract Background Nasal obstruction is a common complaint in the pediatric population. In infants, particularly during the first few months of life, nasal obstruction may be life-threatening because they are preferential nasal breathers. This study aimed to characterize the common causes and clinical findings of nasal obstruction and describe the management modalities used in pediatric patients. Methods This descriptive, cross-sectional, hospital-based study included 217 pediatric patients (< 18 years) presenting with nasal obstruction at Khartoum ENT Teaching Hospital, Sudan, between July 2019 and July 2020. Patients were recruited consecutively. Data were collected using a structured questionnaire developed by the investigators and supplemented by review of patients’ medical records for clinical examination findings, investigations, and management. The study variables included demographic characteristics, clinical presentation, associated symptoms, diagnostic findings, histopathological findings, and treatment modalities. Descriptive statistics were used, with categorical variables summarized as frequencies and percentages. Results Among 217 pediatric patients evaluated for nasal obstruction, bilateral obstruction was the predominant presentation (63.6%), with 40.0% reporting symptoms lasting more than 3 months. Nasal discharge was the most common associated symptom (74.2%), followed by snoring (47.5%) and sneezing (35.0%). Examination and investigations demonstrated decreased nasal lumen in 41.0%, complete nasal obstruction in 13.0%, and nasal foreign bodies in 16.6%. Abnormal nasopharyngeal findings were identified in 35.0%, including nasopharyngeal masses in 33.0%, with histopathology demonstrating inflammatory, benign, and malignant conditions. CT identified closed choana in 11.5%, midnasal stenosis in 3.2%, and nasolacrimal duct cysts in 1.4%. Surgical treatment was provided to 35.1% of patients, medical treatment to 33.2%, and combined medical and surgical treatment to 31.7%; adenoidectomy was the most common surgical procedure (25.7%). Conclusion Pediatric nasal obstruction has diverse clinical and investigative findings and requires individualized management. Nasal discharge was the most frequent associated symptom, while treatment included medical, surgical, and combined approaches. Further multicenter studies are needed to better characterize the causes and management outcomes of pediatric nasal obstruction.