This document discusses treatment options for nasal obstruction in children. The first line of treatment is removing the cause if known and monitoring growth. For severe cases, adenoidectomy with or without tonsillectomy is commonly used to treat nasal obstruction. Early intervention may reverse craniofacial changes, while delayed intervention may require orthognathic surgery later in life. Rapid maxillary expansion is used to widen the maxillary arch and improve nasal patency, especially in patients ages 8-20. After expansion therapy, lower molars are corrected and any overexpansion or diastema in the front teeth can be addressed with fixed braces.

1. TREATMENT

2. 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 .

3. 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 .

4. Delayed intervention :
 Delay in intervention may result in
unsuccessful orthodontic treatment
which may require orthognathic surgery
at an older age .

5. Phase I:Fixed Appliance
Therapy:
 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.

6. 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 .

7. 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 .