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Wheezing like ASTHMA and clear chest. Nasal condition?

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My 2 year old son is having a strange nasal condition. It sounds like wheezing and he has an history of asthma attacks as such the er treated him as an asthmatic and nebulized him 5 times. But on review his chest was clear. Which i knew because whilst it sounds like wheezing this thing is totally nasal. My private doctor also confirmed it was not wheezing but a nasal condition . But she couldnt identify it. She prescribed nasonex and antibiotics as his tonsils were a bit swollen eating as usual playing as normal and is alert but i am not comfortable with the sound of this. Any idea of what it could be?

Category: Pediatrician

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Category: ICU/ Critical Care Specialist
 19 Doctors Online

Hello,
Thank you for your query at DoctorSpring.com

I can understand your situation. This must be very distressing, to see the doctors miss and misdiagnose what appears so obviously non pulmonary in origin.
The diagnosis is 'deviated nasal septum'.
These children have noisy breathing that sounds very similar to a wheeze with the only difference being that the sound originates from nose.
Basically, this condition causes altered flow patterns in the asymmetrical nasal cavities. This condition can be treated surgically by an ENT specialist.
Regards
Dr. Saptharishi


Patient replied :

Ohh. Thank you . But I read that i should wait until he's finished growing to do the surgery, what then are my treatment options in between that time?


Dear Parent,
You are right. Deviated nasal septum needs a definitive surgical correction but at a higher age (usually > 7 years). The age at which surgery is performed varies between centers and countries. The decision also depends on the severity of the condition and the associated complications.
As per the American Academy of Otolaryngology (ENT), Initial treatment of deviated septum may be directed at managing the symptoms of the condition, such as nasal congestion and postnasal drip (if any). The doctor may prescribe:

    • ? Decongestants. Decongestants are medications that reduce nasal congestion, helping to keep the airways on both sides of your nose open. Decongestants are available as a pill or as a nasal spray. Decongestant nasal sprays are not recommended for more than 5 days.
    • ? Antihistamines. Antihistamines are medications that help prevent many cold and allergy symptoms, including runny nose. Some antihistamines cause drowsiness.
      Septoplasty is a surgical procedure performed entirely through the nostrils, accordingly, no bruising or external signs occur. The surgery might be combined with a rhinoplasty, in which case the external appearance of the nose is altered and swelling/bruising of the face is evident. Septoplasty may also be combined with sinus surgery.
      The time required for the operation averages about one to one and a half hours, depending on the deviation. It can be done with a local or a general anesthetic, and is usually done on an outpatient basis. After the surgery, nasal packing is inserted to prevent excessive postoperative bleeding. During the surgery, badly deviated portions of the septum may be removed entirely, or they may be readjusted and reinserted into the nose.
      Kindly visit a ENT specialist in-person for further help as the decision-making hereon would be based on individual needs.
      Wishing your child a speedy recovery.
      Regards
      Dr. Saptharishi L G


Dr. Saptharishi L G
Category: ICU/ Critical Care Specialist
Experience: 
Senior Residency: DM,  Pediatric Critical Care, PGIMER

Residency: MD, Pediatrics, Postgraduate Medical Education & Research (PGIMER), Chandigarh, 2013

Internship: JIPMER, 2009

Medical School: MBBS, Jawaharlal Institute of Post-graduate Medical Education & Research (JIPMER), Puducherry, 2008
Dr. Saptharishi L G and 4 other Medical Specialists are ready to help you

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