Nasal cavity dimensions in congenital pyriform aperture stenosis

Abstract

ObjectiveTo determine the dimensions of the nasal cavity in infants with congenital pyriform aperture stenosis (CPAS). Study designThe nasal cavities of seven children with CPAS were identified and were compared to the nasal cavities of 13 neonates (<30 days old) who had received CT scans for other indications. MethodsThe width of the nasal cavities was measured at the pyriform aperture, choana, and at two standardized points along the lateral nasal wall (LW-1 and LW-2) between the pyriform aperture and choana. ResultsComparison between neonates with and without CPAS demonstrates significant narrowing of the nasal cavity (not just the pyriform aperture) in infants with CPAS. Significantly smaller nasal width was noted at pyriform aperture, LW-1, and LW-2 (p<0.01, p<0.01, p=0.02). No significant narrowing was seen at the choana. ConclusionThese findings suggest that CPAS is associated with narrowing of the anterior 75% of the nasal cavity. This has implications for surgical management because simple pyriform aperture ostectomy may not be sufficient to relieve symptoms of obstruction.