Aspects of differential diagnosis and treatment of rhinitis in children under 2 years of age

Introduction. Clinical manifestations of rhinitis have a negative impact not only on the physical, social, and psychological health of children, but also on their parents, especially in families with a first child. Nasal congestion, nasal breathing difficulty cause problems with sleep and feeding.

Aim of the study. To estimate the occurrence of rhinitis in children under two years old in the outpatient practice of otorhinolar-yngologists, to consider features of the course and differential diagnostics of various rhinitis types, to evaluate the effectiveness of nasal irrigation-elimination therapy in the treatment of acute rhinitis symptoms.

Materials and Methods. Between September 2020 and July 2021, 220 patients between 0 to 18 years were managed: preschool-aged patients comprised 120 patients (54.5%), of whom 27 patients under two years old had symptoms of rhinitis, including those with symptoms lasting more than two weeks.

Results. Among the patients referred to us, infectious rhinitis was diagnosed in the majority of cases - in 18 patients (66,7%), which can be explained not only by the timing of the study but also by the highest prevalence of this pathology among the diseases of the nasal cavity. Allergic and non-allergic rhinitis occurred in only 4 (14.8%) and 5 (18.5%) persons, respectively. Symptomatic irrigation therapy with saline solutions is just as necessary for young children as it is for older children and adults. Some difficulties in nasal cavity care during rhinitis are the anatomical narrowness of the nasal passages and lack of blowing skills in young children. In these situations, preference should be given to gentle, non-traumatic, gentle aspiration with prior irrigation of the nasal cavity with an isotonic saline solution. When a nasal aspirator was used, there was a decrease in the duration of nasal discharge during the illness and a reduction in the duration of the disease.

Conclusion. Rhinitis in young children is a common but underestimated problem. Clinical manifestations are more often associated with typical symptoms: nasal congestion, discharge, nasal breathing difficulty, and sneezing. The use of irrigation-elimination intranasal therapy with the use of a nasal cavity aspirator can reduce the timing of clinical symptoms of rhinitis and reduce the overall duration of the disease.

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