Congenital nasal pyriform aperture stenosis: report of two cases

• Published in: European journal of plastic surgery Vol. 44; no. 4; pp. 527 - 530
• Main Authors: Zatz, Rafael Ferreira, Goldenberg, Julia Alice Cavicchioli, Kharmandayan, Vânia, Gemperli, Rolf, Goldenberg, Dov Charles
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.08.2021
• Subjects: Case Report; Medicine; Medicine & Public Health; Plastic Surgery; Neonates; Nasal obstruction; Congenital; Obstruction; Pyriform aperture stenosis; Upper airway
• ISSN: 0930-343X; 1435-0130
• DOI: 10.1007/s00238-020-01728-7

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.