Congenital nasal pyriform aperture stenosis (CNPAS) is a rare cause of neonatal upper airways obstruction. It can occur as an isolated anomaly or be associated with other cranial-facial defects. Clinically, CNPAS manifests as apneic crises, episodic cyanosis, and difficulty in feeding. Here we report a newborn developing respiratory distress after birth that required oxygen support and was confirmed diagnosis of CNPAS by computed tomography (CT) scan. The newborn had successfully undergone surgical intervention via the nasolabial approach.

Foreign body aspirations represent a life-threatening emergency and continue to pose challenges to the otorhinolaryngology team. The mainstay of treatment remains bronchoscopy, and early removal should be performed to prevent complications. Spontaneous expulsion of an airway foreign body is a rare entity with few cases reported. Additionally, its occurrence and associated complications are still unclear. Besides, an expelled foreign body can be swallowed, migrate to another location, or lodge in a subglottic area. We are reporting an unusual case of a young man who accidentally inhaled a thumb pin. However, the foreign body was expelled without any complications after he suddenly had a severe bout of cough.

Nodular fasciitis (NF) is an uncommon and benign tumour-like fibroblastic proliferation that is difficult to distinguish from sarcoma both clinically and histologically. In addition, it is a type of lesion characterised by having a potential for spontaneous regression. NF is frequently misdiagnosed due to its rapid growth, rich cellularity, and mitotic figure. Although NF is only rarely diagnosed in children, the head and neck represent the most common locations for NF among this population. The cause of NF remains unknown, however trauma is believed to be an important triggering factor. We describe an unusual case of NF in the posterior ethmoid sinus in a six-year-old boy with no history of trauma. The NF was incidentally noted on a computed tomography scan after the patient complained of a squint. The diagnosis of NF was also supported by histopathology and specific immunohistological staining. A surgical biopsy was performed, and no recurrence was observed after one year.

Congenital high airway obstruction syndrome (CHAOS) is a rare life-threatening fetal anomaly which occurs as a result of either partial or complete obstruction of the upper fetal airway. Prenatal recognition is important for multidisciplinary team management. We present a case with CHAOS diagnosed antenatal imaging and the baby was delivered via ex utero intrapartum treatment (EXIT) procedure. The airway managed to be secured via tracheostomy while maintaining the fetus on feto-placental circulation. However, oxygen saturation started to decline despite successfully securing the upper airway.  Unfortunately, we lost the baby despite active resuscitation possibly due to insufficient lung function secondary to chronic obstruction prenatally.