Is There a Role for Non-Operative Management of Congenital Nasal Pyriform Aperture Stenosis (CNPAS)?

Abstract

Is There a Role for Non-Operative Management of Congenital Nasal Pyriform Aperture Stenosis (CNPAS)? Objective: Describe non-operative management of neonates with congenital pyriform aperture stenosis (CNPAS) and examine clinical features of these patients. Study design: Consecutive case series with chart review. Setting: Tertiary, care referral, academic children’s hospital. Subjects and methods: Comparison of patients diagnosed with CNPAS and treated operatively or non-operatively. Results: Eleven patients were included in our study. Of eight patients treated surgically, four were female and four were male. The average diameter of the pyriform aperture of those patients was 5.55 mm. Of the non-operatively managed patients, two were female and one was male. The average diameter of the pyriform aperture was 4.83 mm. There was no significant difference in pyriform aperture dimension between the two groups, p = 0.54. All of the CNPAS patients managed non-operatively were isolated CNPAS cases, while in the surgical managed group, half of the patients had significant medical comorbidities and congenital abnormalities. Conclusion: Non-operative management may be considered in selected patients with CNPAS. Clinical severity of disease should be the primary indicator for surgical or non-operative management.