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 .