title: Nasal pyriform aperture stenosis in adults.
abstract: BACKGROUND
  Congenital nasal pyriform aperture stenosis (CNPAS) leading to respiratory insufficiency in infants has been well documented. Nevertheless, the nasal pyriform aperture stenosis (NPAS) entity in adulthood has not been discussed at all. The normative data of the width of the pyriform aperture, which has not been revealed before, is necessary for evaluation of the adult subjects with nasal bony inlet stenosis. The aim of this study was to define the normative data about the pyriform aperture width measured in 80 adult subjects with paranasal sinus symptoms without nasal obstruction and, additionally, to report the surgical results of two representative cases with NPAS.
  
  
  METHODS
  The nasal bony inlet width measurements have been achieved in axial computerized tomographic sections to establish normative data. The maximal distance between the nasal processes of the opposite maxillary bones was measured. Two adult males complaining of nasal obstruction with overt pyriform aperture stenosis were treated surgically via a sublabial approach.
  
  
  RESULTS
  The mean widest dimension of the nasal pyriform aperture was 21.6 +/- 2.2 mm (range, 17-27 mm) in 80 adult subjects. This width was 21.9 +/- 2.1 mm (range 18-27 mm) in men and 21 +/- 2.2 mm (range, 17-26 mm) in women. Stenotic pyriform apertures in two patients were widened surgically by drilling via a sublabial approach from 12 and 10 mm to 24 and 21 mm, respectively.
  
  
  CONCLUSIONS
  NPAS should be included in the list of differential diagnosis for nasal obstruction. Surgical enlargement using a sublabial approach was found an effective and adequate treatment in pyriform aperture stenosis.
authors.affiliation: Department of Otorhinolaryngology, Inonu University, School of Medicine, Malatya, Turkey.
authors.forename: Tamer
authors.initials: T
authors.lastname: Erdem
authors.forename: Orhan
authors.initials: O
authors.lastname: Ozturan
authors.forename: Gulnur
authors.initials: G
authors.lastname: Erdem
authors.forename: Mustafa
authors.initials: M
authors.lastname: Akarcay
authors.forename: Murat Cem
authors.initials: MC
authors.lastname: Miman
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D003251:Constriction, Pathologic; D003937:Diagnosis, Differential; D005145:Face / Q000002:abnormalities*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009296:Nasal Cavity / Q000002:abnormalities* / Q000033:anatomy & histology* / Q000601:surgery; D015508:Nasal Obstruction / Q000209:etiology*; D012016:Reference Values; D014057:Tomography, X-Ray Computed