Pyriform Aperture Stenosis

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Overview

Pyriform aperture stenosis is a congenital malformation resulting in a narrowed pyriform aperture and subsequent nasal obstruction.

History

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Pathophysiology

Relevant Anatomy

Key anatomy includes the structures of the nasal cavity and midface.

Disease Etiology

Genetics

Diagnosis

Patient History

It is important to take a focused history related to any airway or feeding symptoms, including:

  • Prolonged feeding times
  • Needing frequent breaks during feeds
  • Cyanosis or increased respiratory effort, especially with feeding
  • BRUE's
  • Difficulty placing nasogastric tubes
  • Family history of genetic conditions with anatomic malformations

Physical Examination

Imaging

CT maxillofacial will demonstrate decreased pyriform aperture diameter, especially on axial view. A pyriform aperture width of less than 11 mm is diagnostic for pyriform aperture stenosis.[1]

Differential Diagnosis

Management

Medical Management

Surgical Management

Outcomes

Complications

Prognosis

References

  1. Belden CJ, Mancuso AA, Schmalfuss IM. CT features of congenital nasal piriform aperture stenosis: initial experience. Radiology. 1999 Nov;213(2):495-501.