Causes and treatments of nasal obstruction in children and adolescents: a systematic literature review

Abstract
Objective
To identify the causes and treatments of nasal obstruction in the paediatric population.

Methods
A systematic search of Medline and Embase was conducted to identify the relevant articles. A detailed inclusion and exclusion criterion was developed and implemented to screen the abstracts. Full texts of the selected studies were then assessed to establish their inclusion or exclusion in our review. All relevant data were extracted, and the results were summarised narratively.

Results
Fifty-nine studies met out inclusion-exclusion criteria and were included in this systematic review. All of these primary research studies were categorised into causes and treatments. Cleft lip and palate was the most reported cause of nasal obstruction among congenital causes. However, among the acquired causes, allergic rhinitis was the most reported. Twenty-one of 39 studies described treatments for allergic rhinitis, including perennial rhinitis, 9 for adenoid hypertrophy, 2 for the common cold, 5 for septal deviation, and 2 for chronic rhinosinusitis.

Conclusion
This systematic review provides good evidence regarding the causes and treatments of nasal obstruction. Allergic rhinitis is the most common cause of acquired nasal obstruction, and cetirizine, fexofenadine, fluticasone furoate nasal spray, and mometasone furoate monohydrate nasal are the commonly used treatments to alleviate the symptoms.