A Novel Management Algorithm for Neonatal Rhinitis, A Common Yet Under-Researched Entity
Silvia Marinone Lares, Paediatric ORL Fellow, Starship Child Health, New Zealand
Authors List
Introduction: Newborn children are considered preferential nasal breathers. Nasal obstruction may cause significant respiratory compromise which may be distressing for families and impact a neonate’s development and quality of life. Neonatal rhinitis is a diagnosis of exclusion relating to nasal obstruction and congestion in the first 28 days. While rarely life-threatening, it may require specialist management.
Aims: The aim of this presentation is to review the available literature and provide an up-to-date management algorithm for clinicians that may encounter this condition in their practice.
Methods: Literature review.
Results: There is limited literature regarding this topic. Reported treatments include nasal suction, topical saline, topical decongestants and topical steroid courses of varying duration, in addition to adjunct airway interventions. (1,2)
Conclusions: We propose a novel management algorithm based on current best practice that incorporates supportive treatment, pharmacological therapy, airway adjuncts and surgical options. Use of decongestant should be minimal and courses of topical steroids brief. Nasal steroid sprays are not effective. Possible contributing factors such as gastroesophageal reflux should be treated if present. Those that do not respond to conservative management should undergo further evaluation, especially if surgery is contemplated.
References:
1. Nathan A’ CAO, Seid AB. Neonatal rhinitis. Vol. 39, International Journal of Pediatric Otorhinolaryngology. 1997.
2. Alvo A, Villarroel G, Sedano C. Neonatal nasal obstruction. Vol. 278, European Archives of Oto-Rhino-Laryngology. Springer Science and Business Media Deutschland GmbH; 2021. p. 3605–11.
- Marinone Lares, S., Starship Children's Health, Auckland, New Zealand
- Van der Meer, G., Starship Children's Health, Auckland, New Zealand
Introduction: Newborn children are considered preferential nasal breathers. Nasal obstruction may cause significant respiratory compromise which may be distressing for families and impact a neonate’s development and quality of life. Neonatal rhinitis is a diagnosis of exclusion relating to nasal obstruction and congestion in the first 28 days. While rarely life-threatening, it may require specialist management.
Aims: The aim of this presentation is to review the available literature and provide an up-to-date management algorithm for clinicians that may encounter this condition in their practice.
Methods: Literature review.
Results: There is limited literature regarding this topic. Reported treatments include nasal suction, topical saline, topical decongestants and topical steroid courses of varying duration, in addition to adjunct airway interventions. (1,2)
Conclusions: We propose a novel management algorithm based on current best practice that incorporates supportive treatment, pharmacological therapy, airway adjuncts and surgical options. Use of decongestant should be minimal and courses of topical steroids brief. Nasal steroid sprays are not effective. Possible contributing factors such as gastroesophageal reflux should be treated if present. Those that do not respond to conservative management should undergo further evaluation, especially if surgery is contemplated.
References:
1. Nathan A’ CAO, Seid AB. Neonatal rhinitis. Vol. 39, International Journal of Pediatric Otorhinolaryngology. 1997.
2. Alvo A, Villarroel G, Sedano C. Neonatal nasal obstruction. Vol. 278, European Archives of Oto-Rhino-Laryngology. Springer Science and Business Media Deutschland GmbH; 2021. p. 3605–11.
