Congenital Nasal Pyriform Aperture Stenosis: Successful Management of Restenosis After Primary Surgery by Stent Placement

Botti, Cecilia; Iannella, Elisa; Lusetti, Francesca; Giordano, Davide; Pernice, Carmine; Perano, Daniele; Ghidini, Angelo

doi:10.1177/0145561320942368

Cited by 2 publications

(6 citation statements)

References 6 publications

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“…Botti et al reported that stent removal at four days after the first surgery caused restenosis in the nasal cavities and relapse of respiratory distress and the patient eventually required a second surgery [18]. Although the duration of stenting is variable [17], it is recommended that stents be left in place for approximately one to two weeks [16,18,19]. In the current case, the stent was placed for two weeks, and no restenosis was observed four months postoperatively.…”

Section: Discussionmentioning

confidence: 78%

“…After surgery, stent placement is recommended to prevent restenosis and granulation. In addition to endotracheal tubes, soft silastic nasal stents and standard nasal conformers, usually employed in cleft surgery, are used for stents [3,18]. Botti et al reported that stent removal at four days after the first surgery caused restenosis in the nasal cavities and relapse of respiratory distress and the patient eventually required a second surgery [18].…”

Section: Discussionmentioning

confidence: 99%

“…In addition to endotracheal tubes, soft silastic nasal stents and standard nasal conformers, usually employed in cleft surgery, are used for stents [3,18]. Botti et al reported that stent removal at four days after the first surgery caused restenosis in the nasal cavities and relapse of respiratory distress and the patient eventually required a second surgery [18]. Although the duration of stenting is variable [17], it is recommended that stents be left in place for approximately one to two weeks [16,18,19].…”

Section: Discussionmentioning

confidence: 99%

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Surgical Management of Congenital Nasal Pyriform Aperture Stenosis: A Case Report

Iemura-Kashiwagi¹,

Kikuchi²,

Okuyama³

et al. 2022

Cureus

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Congenital nasal pyriform aperture stenosis (CNPAS) is a rare cause of respiratory distress in newborns. This paper reports a case of severe CNPAS that required endotracheal intubation immediately after birth, and eventually, surgical intervention. At birth, the width of the pyriform aperture was only 4 mm, and the patient was completely unable to breathe through his nose. We performed tracheostomy at 23 days of age and waited for the patient to grow, but at 56 days of age, the width of the pyriform aperture was not sufficient (6 mm) for the patient to breathe through his nose. Therefore, surgical dilation of the pyriform aperture by a sublabial approach was performed on day 79 after birth, and the width was increased to 14 mm. Postoperative stent placement was performed for two weeks. After the removal of the stents, the patient could finally breathe through his nose, and the postoperative course was uneventful, with no restenosis after four months. CNPAS is a rare cause of nasal obstruction, but it can cause respiratory distress in infants because they are dependent on nasal breathing. Conservative treatments are initially recommended for CNPAS; however, in severe cases where conservative treatments are ineffective, surgical treatment is recommended.

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Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Surgical Management of Congenital Nasal Pyriform Aperture Stenosis: A Case Report

Iemura-Kashiwagi¹,

Kikuchi²,

Okuyama³

et al. 2022

Cureus

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“…The sublabial surgical approach has historically been shown to be safe and associated with good surgical outcomes. 24,25 The exposure achievable with this technique prevents damage to soft tissues and avoids visible external scarring. The results are apparent immediately after surgery.…”

Section: Discussionmentioning

confidence: 99%

“…These include injury to the nasal mucosa, nasolacrimal duct, tooth buds, and nasal ala, as well as septal ulceration and postoperative granulation tissue formation causing re-stenosis. 17,25,26…”

Section: Discussionmentioning

confidence: 99%

Comparison of Surgical Techniques for the Treatment of Congenital Nasal Pyriform Aperture Stenosis: A Systematic Review

Rosi-Schumacher,

DiNardo,

Reese

et al. 2024

Ann Otol Rhinol Laryngol

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Introduction: Congenital nasal pyriform aperture stenosis (CNPAS) is a rare condition that results in neonatal respiratory difficulty. The purpose of this systematic review was to compare surgical outcomes of drilling versus dilation techniques in the treatment of CNPAS. Methods: Pubmed, Embase, and Cochrane Clinical Trials databases were searched for terms “congenital nasal pyriform aperture stenosis” or “pyriform aperture stenosis” from 2010 to 2021. Twenty-five studies were included that evaluated pediatric patients treated surgically for CNPAS with available outcomes data including complications, revisions, and length of stay. Results: A total of 51 patients with CNPAS were pooled from included studies. The median age was 29 days, 56.9% were female, and 54.9% were born full-term. The median pyriform aperture width before surgery was 5.00 mm (IQR = 4.10, 6.45). Forty (78.4%) patients underwent sublabial drilling, while 6 had a dilation procedure performed with hegar cervical dilators, 2 had a balloon dilation, and 3 were dilated with either an acrylic device, endotracheal tube, or bougie. There were no post-operative complications for 76.5% of patients, while a second surgery was required in 9 (17.6%) patients. The median length of stay was 11 days (IQR = 4, 26). No statistically significant difference was observed between sublabial drilling and surgical dilation techniques with respect to complications, need for revision surgery, or length of stay. Conclusion: Current literature is insufficient to determine if drilling or dilation is more effective in the treatment of CNPAS.

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Congenital Nasal Pyriform Aperture Stenosis: Successful Management of Restenosis After Primary Surgery by Stent Placement

Cited by 2 publications

References 6 publications

Surgical Management of Congenital Nasal Pyriform Aperture Stenosis: A Case Report

Surgical Management of Congenital Nasal Pyriform Aperture Stenosis: A Case Report

Comparison of Surgical Techniques for the Treatment of Congenital Nasal Pyriform Aperture Stenosis: A Systematic Review

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