Upper Respiratory Tract Infections and Rhino-Pharyngeal Clearance in Children: Myths and Clinical Evidence for a Pictorial Essay

Upper respiratory tract infections (URTI) have a high incidence in young children leading to Eustachian tube dysfunction and middle ear impairment, due to anatomical and physiological connections between these structures. In the last years, pharmacological treatments started to be avoided. Moreover, there is no evidence of an effective pharmacological treatment of URTI in children, since antibiotics are not recommended, neither narcotics, antihistamines nor decongestants. So, an effective rhino-pharyngeal clearance could avoid the deleterious evolution of the health condition of the child by reducing or eliminating nasal secretions, re-establishing nasal breathing, and preventing dissemination which may result in bacterial infection. Several studies have underpinned the benefits and immediate effects of rhino-pharyngeal clearance, such has the improvement of nasal obstruction and middle ear pressure in tympanogram in children under 3 years of age with URTI. However, a consensus on the next research trends and clinical trials are required to establish and implement efficient protocols with adequate treatment monitoring and outcome measures. This article aims to highlight the best evidence, clarify some goals among different areas of expertise, and suggest future research.