Clinical and imaging evaluation of Congenital Midnasal Stenosis

Levi, Lirit; Kornreich, Liora; Hilly, Ohad; Raveh, Eyal; Gilony, Dror

doi:10.1016/j.ijporl.2020.109918

Cited by 6 publications

(10 citation statements)

References 11 publications

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“…The symptoms due to the mid-nasal stenosis improved after several days of conservative topical steroid treatment, while the CA was treated later. 2 However, unlike the patient described in the present report, those babies showed problems of both nasal passages, on physical examination and CT scans.…”

Section: Discussioncontrasting

confidence: 85%

Unilateral Choanal Atresia Presenting With Congenital Respiratory Distress and Recurrent Cyanotic Episodes

et al. 2021

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Congenital unilateral choanal atresia (CA) is not considered an emergent condition and should not cause respiratory distress in the newborn. Therefore, surgical repair of unilateral CA is usually delayed. This description of a newborn with congenital unilateral CA that caused significant respiratory distress, recurrent cyanotic episodes, and severe feeding difficulties highlights an exception to that rule.

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Section: Discussioncontrasting

confidence: 85%

Unilateral Choanal Atresia Presenting With Congenital Respiratory Distress and Recurrent Cyanotic Episodes

et al. 2021

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“…Therefore, atresia, stenosis or severe nasal congestion in the newborn can measurements for diagnosing midnasal stenosis in newborns. 5 In their study, the measurements between the bone of the inferior turbinate and the septum in the midnasal area were significantly different between the newborns diagnosed with midnasal stenosis and the healthy group. 5 However, midnasal stenosis has not been described in adults before.…”

Section: Discussionmentioning

confidence: 89%

“…1–3 Congenital midnasal stenosis has been previously described as a component of many syndromes, but it was first reported precisely in 2004 by Raghavan et al 4 Case series have subsequently been presented, and diagnosis and treatment modalities have been discussed in the literature. 5–8…”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3] Congenital midnasal stenosis has been previously described as a component of many syndromes, but it was first reported precisely in 2004 by Raghavan et al 4 Case series have subsequently been presented, and diagnosis and treatment modalities have been discussed in the literature. [5][6][7][8] Choanal atresia, pyriform aperture stenosis and midnasal stenosis are clinically similar entities. Endoscopic evaluation plays an important role in diagnosis.…”

Section: Introductionmentioning

confidence: 99%

“…These authors have determined comprehensively the normative measurements of neonatal endonasal anatomical distances related to midnasal stenosis. 5 The aetiology of nasal obstruction in adults is different from that of newborns. Nasal obstruction in adults may be due to mucosal causes such as rhinosinusitis and turbinate hypertrophy, or have structural causes such as septal deviation and nasal valve collapse.…”

Section: Introductionmentioning

confidence: 99%

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Midnasal stenosis in adults with normative values

et al. 2022

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Background Congenital midnasal stenosis has previously been described as a cause of nasal obstruction in infants, and conservative and interventional treatments have been suggested. However, midnasal stenosis in adults has not been reported and related normative measurements have not been studied. Methods Three adult patients presented with nasal obstruction and, based on examination and radiological findings, were diagnosed with midnasal stenosis. Anatomical measurements were studied in axial and coronal computed tomography scans, and compared with findings for 161 healthy individuals. Results Anatomical measurements showed that the endonasal cavity was larger in males than females. The midnasal region was found to be constricted in patients compared to healthy controls. Conclusion This is the first study to report on midnasal stenosis in adults and to define normative anatomical measurements in adults. In patients presenting with nasal obstruction, midnasal stenosis should be suspected during endoscopic visualisation of medially located middle turbinates and uncinate processes in nasal cavities. A definitive diagnosis of midnasal stenosis can be made by examining paranasal sinus computed tomography scans. Endoscopic middle turbinectomy, complete uncinectomy, mega maxillary antrostomy and partial anterior ethmoidectomy have been suggested to relieve midnasal stenosis.

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Heated humidified high-flow nasal cannula: a new conservative approach for neonatal nasal stenosis

Havazelet,

Stafler,

Zarzur

et al. 2024

Eur Arch Otorhinolaryngol

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Purpose The aim of this study is to evaluate the efficacy of heated humidified high flow nasal cannula (HFNC) therapy as a conservative treatment option for newborns suffering from nasal stenosis, a condition that often leads to respiratory distress and feeding difficulties. Given the increasing utilization of HFNC in various upper and lower respiratory tract indications, characterized by its flow-based mechanism and minimal mucosal damage, we seek to investigate its potential benefits in this specific patient population. Methods A retrospective chart review of newborns with congenital nasal stenosis treated with HFNC for respiratory distress or feeding difficulties in a pediatric tertiary center between 2014 and 2022. Data were collected for demographic characteristics, clinical presentation and ventilatory requirements, pre and post HFNC application. Results Six infants with nasal stenosis were included in the study cohort. Five were diagnosed with congenital pyriform aperture stenosis, three of whom had additional midnasal stenosis. One patient had nasal synechiae. Two patients had failed surgical treatment and all patients failed conservative treatment prior to HFNC treatment. Following HFNC use, improvement was noted in oxygen saturations, heart and respiratory rates, meal volumes and weight. None of the patients required any additional sinonasal surgical treatment. No complications were observed. Conclusions In this case series, we present the first documented use of HFNC treatment for nasal stenosis, showing favorable results. Further studies with a larger cohort, wider range of conditions and extended follow-up periods are needed to establish the risks and benefits of HFNC for neonatal nasal stenosis.

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Clinical and imaging evaluation of Congenital Midnasal Stenosis

Cited by 6 publications

References 11 publications

Unilateral Choanal Atresia Presenting With Congenital Respiratory Distress and Recurrent Cyanotic Episodes

Unilateral Choanal Atresia Presenting With Congenital Respiratory Distress and Recurrent Cyanotic Episodes

Midnasal stenosis in adults with normative values

Heated humidified high-flow nasal cannula: a new conservative approach for neonatal nasal stenosis

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