Pyriform Aperture Stenosis
Overview
Pyriform aperture stenosis is a congenital malformation resulting in a narrowed pyriform aperture and subsequent nasal obstruction.
History
---
Pathophysiology
Relevant Anatomy
Key anatomy includes the structures of the nasal cavity and midface.
-
Skull with highlighted pyriform aperture
-
Midface anatomy
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
- Choanal Atresia
Management
Medical Management
Surgical Management
Outcomes
Complications
Prognosis
References
- ↑ Belden CJ, Mancuso AA, Schmalfuss IM. CT features of congenital nasal piriform aperture stenosis: initial experience. Radiology. 1999 Nov;213(2):495-501.