Congenital Pyriform Aperture Stenosis: Surgery and Evaluation with Three‐Dimensional Computed Tomography

Abstract

Congenital pyriform aperture stenosis should be suspected whenever there is both severe nasal obstruction and difficulty in passing a small catheter or nasogastric tube through the anterior nasal valve. Operation is the most extreme treatment, but it is effective for congenital pyriform aperture stenosis. Nasal stenting for 7 days seemed to be adequate. The use of three-dimensional computed tomography to evaluate preoperative and postoperative nasal pyriform aperture is effective and reliable.

Solitary median maxillary central incisor, holoprosencephaly and congenital nasal pyriform aperture stenosis in a premature infant: case report

“…Nasal cannula is inserted following surgery in most cases in order to maintain the patency of the airway and prevent restenosis, and the cannula is removed after 1 to 3 weeks. 12 Surgical intervention was not considered in the present case due to lack of apnea, lack of need for respiratory support during the follow-up period, and lack of cyanosis during feeding. Nasal decongestants and dexamethasone-containing nasal drops were used for conservative purposes for the duration of 15 days.…”

“…Van Den Abbeele et al 11 recommended the use of corticosteroid -and epinephrinecontaining nasal drops as the initial conservative approach and they limited the duration of this therapy to 15 days due to side effects. Lee et al 12 have reported surgical intervention in cases with sleep apnea, repeat intubation attempts or failure of extubation, feeding problems accompanied by cyanosis, and cases unresponsive to conservative therapy. The most widely recommended surgical intervention is sublabial incision with which overgrowing bone is removed in order to increase the diameter of pyriform aperture above 11 mm.…”

The use of nasal trumpet as a non-invasive treatment method in congenital nasal stenosis

“…In patients with nasal obstruction-related respiratory distress, the McGovern pacifier and oral airway can be used as conservative treatment 1 . Indications for surgical treatment in cases of nasal obstruction are nasal airway obstruction leading to sleep apnea, a history of repeated intubation or intolerance of intubation, feeding difficulties with concomitant cyanosis or the failure of the conservative treatments applied 8 . If a 5Fr catheter cannot be passed down the nasal passage, this is also an indication for surgical treatment 9 .…”

Incisivo central único de la línea media del maxilar, holoprosencefalia y estenosis congénita del orificio nasal anterior en un recién nacido prematuro: a propósito de un caso

“…Lee y col., 12 informaron la realización de cirugías en los pacientes con apnea del sueño, intentos de intubación repetidos o imposibilidad de extubación, problemas alimentarios acompañados de cianosis y pacientes que no respondieron al tratamiento conservador. La intervención quirúrgica más ampliamente recomendada es la incisión sublabial mediante la cual se elimina la excrecencia para incrementar el diámetro del orificio nasal anterior a más de 11 mm.…”

“…Después de la cirugía, en la mayoría de los casos se inserta una cánula nasal para conservar la permeabilidad de la vía respiratoria y evitar la reestenosis, y la cánula se retira entre 1 y 3 semanas después. 12 No se consideró realizar una intervención quirúrgica en esta paciente debido a que no tenía apnea, a que no requirió asistencia respiratoria durante el seguimiento y a que no presentaba cianosis durante la alimentación. Se administraron descongestivos nasales y gotas nasales con dexametasona con fines conservadores durante 15 días.…”