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Congenital nasal pyriform aperture stenosis: report of two cases

Abstract

Congenital nasal pyriform aperture stenosis is a rare cause for congenital nasal obstruction. There are few publications about this severe condition. We report two cases of newborns diagnosed with congenital nasal pyriform aperture stenosis submitted to surgical treatment. Both had respiratory difficulty since birth, represented clinically by the difficulty during breastfeeding. No concomitant comorbidities were identified. The first patient underwent early surgical treatment, as she presented with severe respiratory distress. The second patient had failed conservative treatment and was also subjected to the surgical widening of the pyriform aperture. Both patients evolved uneventfully in the postoperative period. Congenital nasal pyriform aperture stenosis is part of the differential diagnosis of congenital nasal obstruction, being choanal atresia the most common finding. Its clinical presentation can vary from mild respiratory distress, which only disables breastfeeding, to respiratory failure at rest. As it is a rare occurrence, with few publications, its management is still controversial. The need for surgical management in both reported cases and a favorable evolution are highlighted, allowing hospital discharge and adequate breastfeeding.

Level of evidence: Level V, therapeutic study.

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Correspondence to Dov Charles Goldenberg.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The Human Investigation Committee (IRB) of University of São Paulo (Hospital das Clínicas da Faculdade de Medicina da USP) approved this study. Appraisal Number: 3.899.457.

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Informed consent was obtained from the parents or legal guardians of the two pediatric patients included in this study.

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Zatz, R.F., Goldenberg, J.A.C., Kharmandayan, V. et al. Congenital nasal pyriform aperture stenosis: report of two cases. Eur J Plast Surg 44, 527–530 (2021). https://doi.org/10.1007/s00238-020-01728-7

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Keywords

  • Nasal obstruction
  • Congenital
  • Pyriform aperture stenosis
  • Neonates
  • Upper airway
  • Obstruction