Congenital Nasal Pyriform Aperture Stenosis

Area of Science:

• Otolaryngology
• Pediatric Surgery
• Medical Imaging

Background:

• Congenital nasal pyriform aperture stenosis (CNPAS) is an uncommon condition causing neonatal stridor and airway compromise.
• Early diagnosis and intervention are crucial for managing this potentially life-threatening condition.

Purpose of the Study:

• To present a case report on the management of congenital CNPAS in an 8-day-old female infant.
• To discuss the etiology, clinical presentation, diagnostic approaches, and treatment options for CNPAS.

Main Methods:

• Diagnostic suspicion arose from the inability to pass a 5Fr nasogastric tube, suggesting choanal atresia or pyriform aperture stenosis (PAS).
• Computed tomography (CT) scan of the paranasal sinuses was utilized for definitive diagnosis.
• Transnasal endoscopic dilatation and stenting with an 8Fr nasogastric tube under general anesthesia were performed.

Main Results:

• Successful endoscopic dilatation and stenting were achieved in the infant.
• The diagnostic pathway involving nasogastric tube passage and CT imaging was effective.
• The chosen treatment modality provided a resolution for the airway obstruction.

Conclusions:

• CNPAS requires prompt recognition and appropriate management to prevent severe respiratory distress.
• CT imaging is the gold standard for diagnosing PAS.
• Endoscopic techniques offer a viable and effective treatment for congenital pyriform aperture stenosis.