Congenital pyriform aperture stenosis: surgery and evaluation with three-dimensional computed tomography.
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.
Lee
Kuo-Sheng
KS
Department of Otolaryngology-Head and Neck Surgery, Mackay Memorial Hospital, Taipei, Taiwan.
Yang
Cheng-Chien
CC
Huang
Jon-Kway
JK
Chen
Yu-Chun
YC
Chang
Ke-Chang
KC
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