A 4-year-old child presents with bilateral nasal obstruction, mouth breathing, and snoring for 6 months. Examination reveals a flat facial profile and dental malocclusion. The most likely diagnosis is:

• A Nasal polyposis
• B Choanal atresia
• C Juvenile nasopharyngeal angiofibroma
• D Adenoid hypertrophy with adenoid facies ✓

Explanation

The clinical picture of bilateral nasal obstruction, mouth breathing, snoring, flat facial profile, and dental malocclusion in a child is classic for adenoid facies due to chronic adenoid hypertrophy. Nasal polyposis is rare in young children and does not cause the characteristic facial profile. JNA typically presents in adolescent males with unilateral nasal obstruction and epistaxis. Choanal atresia presents at birth with feeding difficulties.

Reference: Diseases of Ear, Nose and Throat, 7th ed.

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Written and medically reviewed by the StethoPrep medical team.