title: Neonatal iatrogenic nasal obstruction.
abstract: OBJECTIVE
  To define the etiology, management and prevention of iatrogenic neonatal nasal obstruction caused by intra-nasal synechia (INS).
  
  
  METHODS
  Case series retrospectively reviewed, years 2001-2002.
  
  
  METHODS
  Tertiary care children's hospital.
  
  
  METHODS
  Four neonates, ages 2 weeks to 3 months, evaluated for nasal obstruction and consequent respiratory distress. Endoscopic findings were of intra-nasal synechia caused by previous intra-nasal invasive interventions.
  
  
  METHODS
  The procedures inciting the formation of synechia, possible management problems leading to synechia formation, clinical presentation, treatment and results of treatment were documented.
  
  
  RESULTS
  Initial incorrect diagnosis and management with an inappropriate intervention was found to be a possible cause of nasal obstruction due to synechia formation in three of these patients (two with associated craniofacial anomalies). In one patient complete nasal obstruction due to synechia was a result of continuous positive airway pressure (CPAP) intra-nasal catheters. Treatment including endoscopic synechiolysis resulted in an improved airway but not a complete cure. All patients required multiple procedures to attain a satisfactory nasal airway.
  
  
  CONCLUSIONS
  Careful initial diagnosis and management of neonatal nasal obstruction may prevent severe complications caused by synechia in the nasal cavity.
authors.affiliation: Pediatric Otolaryngology Unit, "Dana" Children's Hospital, Tel-Aviv Medical Center, 6 Weitzman St., Tel-Aviv 64239, Israel. aderowe@post.tau.ac.il
authors.forename: Ari
authors.initials: A
authors.lastname: DeRowe
authors.forename: Roee
authors.initials: R
authors.lastname: Landsberg
authors.forename: Gadi
authors.initials: G
authors.lastname: Fishman
authors.forename: Doron
authors.initials: D
authors.lastname: Halperin
authors.forename: Dan
authors.initials: D
authors.lastname: Fliss
mesh_terms: D004106:Dilatation / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D007223:Infant; D007231:Infant, Newborn; D007440:Intubation / Q000009:adverse effects*; D015508:Nasal Obstruction / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D015607:Stents / Q000009:adverse effects*