title: Congenital pyriform aperture stenosis: surgery and evaluation with three-dimensional computed tomography.
abstract: OBJECTIVE
  We described the surgical efficacy of congenital pyriform aperture stenosis by measuring the width of the nasal pyriform aperture with three-dimensional computed tomography.
  
  
  METHODS
  Six patients with congenital pyriform aperture stenosis accepted surgical intervention. Three-dimensional computed tomography was performed for preoperative and postoperative evaluation of nasal pyriform aperture width. We marked the midpoint between the tip of nasal bone and the anterior nasal spine. The distances between the bilateral nasal processes of the maxilla and between the lateral rims of the pyriform aperture were measured by crossing the midpoint horizontally.
  
  
  RESULTS
  Among the six patients (three male and three female patients), the mean age was 76.2+/-23.9 days. Silicon stents were removed 6 to 7 days after operation. During 9 months of follow-up, there were no cases of restenosis, respiratory failure, or cyanosis. The mean preoperative and postoperative interprocess distances were 4.5+/-0.84 and 8.7+/-1.37 mm, respectively, and data were statistically significant at a confidence level of P <.05. The mean preoperative and postoperative interwall distances were 9.8+/-0.75 and 10.8+/-1.5 mm, respectively.
  
  
  CONCLUSIONS
  Congenital pyriform aperture stenosis should be suspected whenever there is both severe nasal obstruction and difficulty in passing a small catheter or nasogastric tube through the anterior nasal valve. Operation is the most extreme treatment, but it is effective for congenital pyriform aperture stenosis. Nasal stenting for 7 days seemed to be adequate. The use of three-dimensional computed tomography to evaluate preoperative and postoperative nasal pyriform aperture is effective and reliable.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Mackay Memorial Hospital, Taipei, Taiwan.
authors.forename: Kuo-Sheng
authors.initials: KS
authors.lastname: Lee
authors.forename: Cheng-Chien
authors.initials: CC
authors.lastname: Yang
authors.forename: Jon-Kway
authors.initials: JK
authors.lastname: Huang
authors.forename: Yu-Chun
authors.initials: YC
authors.lastname: Chen
authors.forename: Ke-Chang
authors.initials: KC
authors.lastname: Chang
mesh_terms: D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D007223:Infant; D007231:Infant, Newborn; D008437:Maxilla / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000601:surgery; D009296:Nasal Cavity / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000601:surgery; D015508:Nasal Obstruction / Q000151:congenital* / Q000000981:diagnostic imaging / Q000601:surgery; D012127:Respiratory Distress Syndrome, Newborn / Q000000981:diagnostic imaging / Q000601:surgery*; D012225:Rhinoplasty; D014057:Tomography, X-Ray Computed