Sublabial Approach for Repair of Congenital Nasal Pyriform Aperture Stenosis: How I Do It

2021 ◽  
Author(s):  
Martha Luitje ◽  
Nathan Vandjelovic ◽  
Margo McKenna Benoit ◽  
John Faria
Keyword(s):  
Sublabial Approach ◽  
Pyriform Aperture

Congenital Nasal Pyriform Aperture Stenosis: Diagnosis and Management

2009 ◽  
Vol 46 (3) ◽  
pp. 262-267 ◽  
Author(s):  
Marion Devambez ◽  
Alexis Delattre ◽  
Pierre Fayoux
Keyword(s):  
Surgical Treatment ◽  
Genetic Disorder ◽  
Tertiary Care ◽  
Case Series ◽  
University Hospital ◽  
Treatment Modalities ◽  
Nasal Decongestants ◽  
Sublabial Approach ◽  
Pyriform Aperture

Objectives: To review diagnosis and treatment modalities in congenital nasal pyriform aperture stenosis in a newborn population. Study Design: A 6-year retrospective case series review. Mean follow-up of 21.8 months. Setting: University hospital, tertiary care center. Patients: Twenty-one consecutive patients treated for congenital nasal pyriform aperture stenosis. Diagnosis was suspected on physical examination and confirmed by computed tomography scan. Associated abnormalities were present in 15 patients. Surgical Treatment: Nineteen patients underwent surgical treatment focused on external bony margins of pyriform aperture and the osseous anterior edge of the inferior turbinate, drilling by a sublabial approach and associated with a partial turbinectomy in seven cases. A stent was placed for 7 to 10 days. A conservative treatment based on topical nasal decongestants and gastroesophageal reflux treatment was proposed for two patients. Results: Postoperative follow-up revealed septal ulceration in five cases with septal perforation in one case and development of synechiae in two cases. Follow-up revealed normal nasal breathing and pyriform aperture growth after surgery. Conclusion: Our experience confirmed the link described between congenital nasal pyriform aperture stenosis and holoprosencephaly, but associated extracraniofacial malformations suggest that congenital nasal pyriform aperture stenosis should be integrated in a systemic malformative syndrome or genetic disorder and lead us to propose an exhaustive dysmorphology assessment. Some infants may be treated by conservative management, and severely affected patients may undergo surgery by a sublabial approach.

A Complicated Case of Congenital Nasal Pyriform Aperture Stenosis: Use of a Long-term Unilateral Nasal Stent

2019 ◽  
Vol 56 (9) ◽  
pp. 1239-1242
Author(s):  
Carol Li ◽  
Mahmoud Awad ◽  
Alison M. Maresh
Keyword(s):  
Surgical Repair ◽  
Inferior Turbinate ◽  
Full Term ◽  
Complicated Case ◽  
Intranasal Steroids ◽  
Term Baby ◽  
Sublabial Approach ◽  
Pyriform Aperture ◽  
Turbinate Reduction

This case describes a full-term baby with pyriform aperture stenosis who failed intranasal dexamethasone and reflux therapy. She underwent repair via a sublabial approach and inferior turbinate reduction. Symptoms initially improved but she was unable to be weaned from intranasal steroids. Three subsequent surgeries ensued, including lysis of synechiae, further turbinate reduction, and placement of custom nasal stents, which failed as they became clogged frequently and were easily dislodged, leading to increased intranasal manipulation and postprocedural inflammation. She was eventually fitted and discharged with a large, unilateral stent. After 8 weeks, the stent was removed; she was tolerating full oral feeds. This case highlights the limitations of surgical repair and describes nontraditional uses of stenting.

Congenital pyriform aperture stenosis: Surgical enlargement via the sublabial approach

1997 ◽  
Vol 117 (2) ◽  
pp. P215-P215
Author(s):  
R RUBINSTEIN ◽  
D RESPLER ◽  
S CHANDRASEKHAR
Keyword(s):  
Sublabial Approach ◽  
Pyriform Aperture

scholarly journals Complications of Poly-l-Lactic Acid and Polyglycolic Acid (PLLA/PGA) Osteosynthesis Systems for Maxillofacial Surgery: A Retrospective Clinical Investigation

Polymers ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 889
Author(s):  
Yuhei Matsuda ◽  
Masaaki Karino ◽  
Tatsuo Okui ◽  
Takahiro Kanno
Keyword(s):  
Postoperative Complications ◽  
Clinical Investigation ◽  
Maxillofacial Surgery ◽  
Multivariate Logistic Regression Analysis ◽  
Polyglycolic Acid ◽  
Oral And Maxillofacial Surgery ◽  
Low Incidence ◽  
Adjusted Model ◽  
Pyriform Aperture ◽  
Plate System

Two second-generation PLLA/PGA bioresorbable osteosynthetic plate systems for oral and maxillofacial surgery are available in Japan. The two systems have different PLLA-PGA component ratios (RapidSorb®, 85:15; Lactosorb®, 82:18) and plate and screw shapes. We conducted a retrospective study to compare our clinical evaluation and examine the incidence of postoperative complications between the two plate systems. A retrospective survey was conducted in 148 patients (midfacial fracture/trauma (68.2%) and dentofacial deformity patients (31.8%); males (54.7%); median age, 37.5 years) treated using maxillofacial osteosynthetic plate systems. The complications included plate exposure (7.4%), infection, (2.7%), and plate breakage (0.7%). Multivariate logistic regression analysis showed a significant correlation between sex (female), plate system (Lactosorb®), number of plates, and pyriform aperture and periorbital sites of plate placement (p < 0.05). Additionally, the propensity score-adjusted model showed a significant correlation between Lactosorb® and postoperative complications (odds ratio 1.007 (95% confidence interval, 1.001–1.055), p < 0.01). However, the two plate systems showed a low incidence rate of complications, and the plate integration and survivability were similar using 2.0-mm or 1.5-mm resorbable plate regardless of the plate system. Our findings suggest that female sex and a greater number of plates are risk factors for postoperative complications, whereas pyriform aperture and periorbital plate placements reduce the risk.

W-Shaped Osteotomy to Avoid Paranasal Deformity After Standard Le Fort I in Orthognathic Surgery

2020 ◽  
pp. 229255032096965
Author(s):  
Mario Santagata ◽  
Nicola Sgaramella ◽  
Fabrizio Chirico ◽  
Salvatore D’Amato ◽  
Ivo Ferrieri ◽  
...  
Keyword(s):  
Orthognathic Surgery ◽  
Preliminary Report ◽  
Le Fort I Osteotomy ◽  
Maxillary Bone ◽  
Le Fort ◽  
First Time ◽  
Le Fort I ◽  
Pyriform Aperture

When occlusal alterations are not accompanied by paranasal deficiencies, mobilization of the maxilla via Le Fort I osteotomy should be made with a different design. In this preliminary report, a W-shaped osteotomy that doesn’t change the position of the maxillary bone surrounding the pyriform aperture was presented for the first time. Advantages and indications of this new procedure are discussed.

scholarly journals Sublabial Approach for Symptomatic Basilar Impression

Neurosurgery ◽  
2012 ◽  
Vol 70 (4) ◽  
pp. E1054-E1055 ◽  
Author(s):  
Kaveh Asadi-Moghaddam ◽  
Bradley A. Otto ◽  
Ricardo L. Carrau ◽  
Daniel M. Prevedello
Keyword(s):  
Basilar Impression ◽  
Sublabial Approach
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