RESUMO
Neonates are obligatory nasal breathers hence nasal obstruction is a very important symptom to be evaluated. Although causes can be trivial most of the time, they can be life-threatening in some. Respiratory distress immediately after birth, feeding difficulties, paradoxical cyanosis, and failure to thrive are the most evident symptoms, and determination of unilateral or bilateral involvement guides the rationale for elective or emergency intervention. This study aimed to evaluate the causes, presentation, and management of neonates with nasal obstruction. We collected the data of all the neonates evaluated for nasal obstruction at our hospital over the past 20 years from June 2003 to May 2023 and assessed the strategy of approach for diagnosis and management of those cases. In our study, the commonest cause for neonatal nasal obstruction was found to be choanal atresia and the rarest was iatrogenic. A variety of other causes were also reported. As neonatal nasal obstruction has a multitude of rare causes each carries a unique assessment and treatment plan. History taking and clinical examination are the most important parts of evaluation including endoscopic evaluation in an office-based setup. Imaging studies add to the evaluation of cases of anatomical obstructions and associated anomalies (syndromes). Early diagnosis and swift intervention can be life-saving. The need for follow-up visits and second-stage corrections should be emphasized in getting the best long-term results.
RESUMO
Objectives: To analyze the effects of chronic adenoid hypertrophy on quality of life (QOL) of children and caregivers and compare quality of life of child before and after adenoidectomy. Materials & Methods: Prospective, observational before and after questionnaire based assessment study at a pediatric otorhinolaryngology specialty center in a metropolitan quaternary care hospital. Children aged between 2 and 12 years undergoing adenoidectomy were included. Parents were asked to fill the Obstructive Sleep Apnea-18 (OSA-18) Quality of Life Index Questionnaire one day before surgery and after one month of surgery during their scheduled follow-up visit. The study was conducted over a period of 1 year and total of 40 children's assessment was done. Results were tabulated and analyzed. Results: The mean age of presentation was 6 years. Based on OSA-18 quality of life assessment scoring the total pre-operative mean score was 73.3 and post-operative was 40.5. There was significant change in OSA-18 total score and individual domain scores post-operatively indicating significant improvement in QOL post adenoidectomy. The domains most affected due to chronic adenoid hypertrophy were physical suffering, caregiver concerns and sleep disturbance (p value < 0.001).Conclusion: Chronic adenoid hypertrophy has major impact on quality of life of a child along with caregiver concern and they show significant improvement after adenoidectomy. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-023-04000-z.