Remove the cause : First line of treatment is to remove the cause if it is known and monitor the growth . For severe cases , Adenoidectomy with or without tonsillectomy is by far the most common treatment for nasal obstruction in children .
Early intervention : Early intervention to correct nasal obstruction may lead to reversal of the associated craniofacial changes . Some of these changes can be noted as young as age three but most are commonly detected at about age five .
Delayed intervention : Delay in intervention may result in unsuccessful orthodontic treatment which may require orthognathic surgery at an older age .
Phase I:Fixed ApplianceTherapy: Rapid maxillary ( Palatal ) expansion (RME) is an orthodontic treatment to broaden the maxillary arch which also serves to widen the nasal vault and improve nasal patency. It is indicated in the late mixed dentition and contraindicated in primary dentition.
Cont... It can be accomplished in about 3 weeks in patients 8 to 20 years of age . No need for expansion of the mandibular arch because most cases with large mandible and constricted maxilla . If mandibular arch is constricted , we can use slow mandibular expansion therapy .
Phase II :dental compensation After expansion therapy , The lingually inclined lower molar will be corrected spontaneously . Also , patient may slightly overexpanded and diastema in the maxillary anterior region , although these can be corrected easily by full-fixed braces .