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Newborn nasal obstruction due to congenital nasal pyriform aperture stenosis

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 growt...

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Autores principales: Serrano, Thiago L. I., Pfeilsticker, Leopoldo, Silva, Vanessa, Hazboun, Igor, Paschoal, Jorge, Maunsell, Rebecca, Sakano, Eulalia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: OceanSide Publications, Inc. 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4837133/
https://www.ncbi.nlm.nih.gov/pubmed/27103559
http://dx.doi.org/10.2500/ar.2016.7.0146
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author Serrano, Thiago L. I.
Pfeilsticker, Leopoldo
Silva, Vanessa
Hazboun, Igor
Paschoal, Jorge
Maunsell, Rebecca
Sakano, Eulalia
author_facet Serrano, Thiago L. I.
Pfeilsticker, Leopoldo
Silva, Vanessa
Hazboun, Igor
Paschoal, Jorge
Maunsell, Rebecca
Sakano, Eulalia
author_sort Serrano, Thiago L. I.
collection PubMed
description 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.
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spelling pubmed-48371332016-04-27 Newborn nasal obstruction due to congenital nasal pyriform aperture stenosis Serrano, Thiago L. I. Pfeilsticker, Leopoldo Silva, Vanessa Hazboun, Igor Paschoal, Jorge Maunsell, Rebecca Sakano, Eulalia Allergy Rhinol (Providence) Articles 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. OceanSide Publications, Inc. 2016 /pmc/articles/PMC4837133/ /pubmed/27103559 http://dx.doi.org/10.2500/ar.2016.7.0146 Text en Copyright © 2016, OceanSide Publications, Inc., U.S.A. This publication is provided under the terms of the Creative Commons Public License ("CCPL" or "License"), in attribution 3.0 unported (Attribution Non-Commercial No Derivatives (CC BY-NC-ND)), further described at: http://creativecommons.org/licenses/by-nc-nd/3.0/legalcode. The work is protected by copyright and/or other applicable law. Any use of the work other then as authorized under this license or copyright law is prohibited.
spellingShingle Articles
Serrano, Thiago L. I.
Pfeilsticker, Leopoldo
Silva, Vanessa
Hazboun, Igor
Paschoal, Jorge
Maunsell, Rebecca
Sakano, Eulalia
Newborn nasal obstruction due to congenital nasal pyriform aperture stenosis
title Newborn nasal obstruction due to congenital nasal pyriform aperture stenosis
title_full Newborn nasal obstruction due to congenital nasal pyriform aperture stenosis
title_fullStr Newborn nasal obstruction due to congenital nasal pyriform aperture stenosis
title_full_unstemmed Newborn nasal obstruction due to congenital nasal pyriform aperture stenosis
title_short Newborn nasal obstruction due to congenital nasal pyriform aperture stenosis
title_sort newborn nasal obstruction due to congenital nasal pyriform aperture stenosis
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4837133/
https://www.ncbi.nlm.nih.gov/pubmed/27103559
http://dx.doi.org/10.2500/ar.2016.7.0146
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