Nasal obstruction in neonates: Two cases report of congenital nasal pyriform aperture stenosis

Abstract

Congenital nasal pyriform aperture stenosis (CNPAS) is a rare form of nasal obstruction in neonates who are obligate nasal breathers, that may become a potential lifethreatening condition. Differential diagnosis must include the more common occurrence of choanal atresia. CNPAS is often characterized by episodic apnea and cyclical cyanosis, and the diagnosis is confirmed upon imaging findings. CNPAS may appear isolated or associated with cranio-facial anomalies, hypopituitarism and abnormal karyotype. Surgery should be considered if patients do not improve with medical treatment. The main purpose of this article is to report two cases of CNPAS. In the first case, the stenosis was diagnosed after birth, there were no other anomalies identified and the child overcame the situation with topical treatment only. In the second case the child presented another midline anomaly, consisting in one single central maxillary incisor. Due to the degree of obstruction and clinical symptoms it was performed a sublabial surgical approach of the stenosis. Both children have no complaints so far.