Congenital Nasal Pyriform Aperture Stenosis (CNPAS): Sublabial Approach to Surgical Correction

CSurgeries ◽  
2017 ◽  
Author(s):  
Madison Clampkin
Keyword(s):  
Surgical Correction ◽  
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 Newborn Nasal Obstruction due to Congenital Nasal Pyriform Aperture Stenosis

2016 ◽  
Vol 7 (1) ◽  
pp. ar.2016.7.0146 ◽  
Author(s):  
Thiago L. I. Serrano ◽  
Leopoldo Pfeilsticker ◽  
Vanessa Silva ◽  
Igor Hazboun ◽  
Jorge Paschoal ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Respiratory Distress ◽  
Nasal Cavity ◽  
Nasal Obstruction ◽  
Treatment Strategies ◽  
Rare Condition ◽  
Surgical Correction ◽  
Severe Respiratory Distress ◽  
First Case ◽  
Pyriform Aperture

Introduction Nasal obstruction is an important condition that can lead to severe respiratory distress in newborns. There are several differential diagnoses, and one of them is congenital nasal pyriform aperture stenosis (CNPAS). CNPAS is a rare case of respiratory distress caused by excessive growth of the nasal process of the maxilla and leads to narrowing of the anterior third of the nasal cavity. Diagnosis, associated anomalies, and treatment strategies are reviewed by the following presentation of two cases. Case Presentation We report two cases of infants diagnosed with CNPAS. The patients in the first case had no concomitant comorbidities, and the outcome was successful after surgical correction of stenosis. The patient in the second case had an associated holoprosencephaly, and although surgical correction and nasal cavity patency, the patient remains dependent on tracheostomy due to dysphagia and neurologic impairment. Discussion Airway obstruction affects 1 in 5000 children, and CNPAS is a diagnosis frequently forgotten and even unknown to neonatal and pediatric intensivists. Newborns are obligate nasal breathers, and, nasal obstruction, therefore, can lead to severe respiratory distress. CNPAS is not only rare but, many times, is not easily recognized. It is important to bear in mind the diagnostic criteria when evaluating infants with nasal obstruction. Conservative treatment should be prioritized, but surgical treatment is required in severe cases with failure to thrive and persistent respiratory distress. Respiratory distress and dysphagia may persist to some degree despite correction of the stenotic pyriform aperture due to associated narrowing of the entire nasal cavity and association with other anomalies. Final Comments CNPAS is a rare condition and may be lethal in newborns. Differential diagnosis of nasal obstruction must be remembered to recognize this anomaly, and the otolaryngologist must be familiarized with this condition and its diagnosis. Precise surgical treatment in severe cases have high rates of success in children without other comorbidities.

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

511: Factors Involved in Parental Decision-Making for Surgical Correction of Vesicoureteral Reflux

2007 ◽  
Vol 177 (4S) ◽  
pp. 170-170
Author(s):  
Pamela I. Ellsworth ◽  
Katherine Callaghan ◽  
Eileen Gray ◽  
Anthony Caldamone
Keyword(s):  
Decision Making ◽  
Vesicoureteral Reflux ◽  
Surgical Correction ◽  
Parental Decision ◽  
Parental Decision Making

Surgical Correction of the Craniofacial Anomalies in Apert Syndrome

1991 ◽  
Vol 18 (2) ◽  
pp. 277-289 ◽  
Author(s):  
John B. Mulliken ◽  
Richard J. Bruneteau
Keyword(s):  
Surgical Correction ◽  
Apert Syndrome ◽  
Craniofacial Anomalies
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