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Pyriform aperture stenosis

MedGen UID:
825835
•Concept ID:
C3839990
•
Congenital Abnormality
Synonym: Congenital stenosis of nasal pyriform aperture
SNOMED CT: Pyriform aperture stenosis (702644002); Congenital stenosis of nasal pyriform aperture (702644002)
 
HPO: HP:0025011

Definition

Narrowing of the anterior nasal aperture (piriform or pyriform aperture), which is a pear-shaped opening in the skull that forms the bony inlet of the nose. [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVPyriform aperture stenosis

Conditions with this feature

Solitary median maxillary central incisor syndrome
MedGen UID:
326686
•Concept ID:
C1840235
•
Congenital Abnormality
A single maxillary central incisor positioned in the midline with morphological symmetry of the crown and bordered by lateral incisors.
See: Condition Record
Solitary median maxillary central incisor syndrome

Professional guidelines

PubMed

Congenital bony nasal cavity stenosis: A review of current trends in diagnosis and treatment.
Galluzzi F, Garavello W, Dalfino G, Castelnuovo P, Turri-Zanoni M
Int J Pediatr Otorhinolaryngol 2021 May;144:110670. Epub 2021 Mar 6 doi: 10.1016/j.ijporl.2021.110670. PMID: 33706014
Congenital nasal pyriform aperture stenosis: Diagnosis, management and technical considerations.
Marrugo Pardo GE, Parra Charris JS, Parra Charris AE, Villa Zuluaga DF
Acta Otorrinolaringol Esp (Engl Ed) 2020 May-Jun;71(3):154-159. Epub 2019 Sep 5 doi: 10.1016/j.otorri.2019.05.001. PMID: 31495444
Congenital nasal pyriform aperture stenosis: conservative management.
Collins B, Powitzky R, Enix J, Digoy GP
Ann Otol Rhinol Laryngol 2013 Oct;122(10):601-4. PMID: 24294681

Recent clinical studies

Etiology

Congenital nasal pyriform aperture stenosis; our experience of 34 cases.
Chakravarty PD, Sim F, Slim MAM, Patel N, Wynne DM, Clement WA
Int J Pediatr Otorhinolaryngol 2023 Mar;166:111491. Epub 2023 Feb 27 doi: 10.1016/j.ijporl.2023.111491. PMID: 36870158
Obstructive sleep apnea in infants.
Katz ES, Mitchell RB, D'Ambrosio CM
Am J Respir Crit Care Med 2012 Apr 15;185(8):805-16. Epub 2011 Dec 1 doi: 10.1164/rccm.201108-1455CI. PMID: 22135346Free PMC Article
Congenital nasal pyriform aperture stenosis: a report of 10 cases and literature review.
Visvanathan V, Wynne DM
Int J Pediatr Otorhinolaryngol 2012 Jan;76(1):28-30. Epub 2011 Oct 22 doi: 10.1016/j.ijporl.2011.09.016. PMID: 22024577
An improved, practical stent for choanal atresia and pyriform aperture stenosis repair.
Javia LR, Shah UK, Germiller JA
Otolaryngol Head Neck Surg 2009 Feb;140(2):259-61. doi: 10.1016/j.otohns.2008.11.018. PMID: 19201300
Midface anomalies in children.
Lowe LH, Booth TN, Joglar JM, Rollins NK
Radiographics 2000 Jul-Aug;20(4):907-22; quiz 1106-7, 1112. doi: 10.1148/radiographics.20.4.g00jl07907. PMID: 10903683

Diagnosis

Congenital nasal pyriform aperture stenosis: Diagnosis and surgical approach (with video).
Azevedo C, Ribeiro D, Lima A
Eur Ann Otorhinolaryngol Head Neck Dis 2021 Aug;138 Suppl 1:31-32. Epub 2021 Jun 22 doi: 10.1016/j.anorl.2020.10.015. PMID: 34167922
Neonatal nasal obstruction.
Alvo A, Villarroel G, Sedano C
Eur Arch Otorhinolaryngol 2021 Oct;278(10):3605-3611. Epub 2021 Jan 3 doi: 10.1007/s00405-020-06546-y. PMID: 33388986
Pediatric Nasal Obstruction.
Smith MM, Ishman SL
Otolaryngol Clin North Am 2018 Oct;51(5):971-985. Epub 2018 Jul 19 doi: 10.1016/j.otc.2018.05.005. PMID: 30031550
Pyriform aperture enlargement in all aspects.
Esen E, Bayar Muluk N, Altintoprak N, Ipci K, Cingi C
J Laryngol Otol 2017 Jun;131(6):476-479. Epub 2017 Feb 27 doi: 10.1017/S0022215117000391. PMID: 28238296
Nasal obstruction in newborns.
Gnagi SH, Schraff SA
Pediatr Clin North Am 2013 Aug;60(4):903-22. Epub 2013 Jul 3 doi: 10.1016/j.pcl.2013.04.007. PMID: 23905827

Therapy

Clinical and imaging evaluation of Congenital Midnasal Stenosis.
Levi L, Kornreich L, Hilly O, Raveh E, Gilony D
Int J Pediatr Otorhinolaryngol 2020 May;132:109918. Epub 2020 Feb 1 doi: 10.1016/j.ijporl.2020.109918. PMID: 32035350
Iatrogenic Cushing's syndrome and adrenal insufficiency in infants on intranasal dexamethasone drops for nasal obstruction - Case series and literature review.
Joshi RR, Maresh A
Int J Pediatr Otorhinolaryngol 2018 Feb;105:123-126. Epub 2017 Nov 11 doi: 10.1016/j.ijporl.2017.11.007. PMID: 29447799
Congenital nasal pyriform aperture stenosis: conservative management.
Collins B, Powitzky R, Enix J, Digoy GP
Ann Otol Rhinol Laryngol 2013 Oct;122(10):601-4. PMID: 24294681
Congenital nasal pyriform aperture stenosis: diagnosis and management.
Devambez M, Delattre A, Fayoux P
Cleft Palate Craniofac J 2009 May;46(3):262-7. Epub 2008 Apr 11 doi: 10.1597/07-182.1. PMID: 19642747
The measurement of congenital nasal pyriform aperture stenosis in infant.
Lee JC, Yang CC, Lee KS, Chen YC
Int J Pediatr Otorhinolaryngol 2006 Jul;70(7):1263-7. Epub 2006 Mar 15 doi: 10.1016/j.ijporl.2006.01.005. PMID: 16540178

Prognosis

Choanal Atresia and Other Neonatal Nasal Anomalies.
Rajan R, Tunkel DE
Clin Perinatol 2018 Dec;45(4):751-767. Epub 2018 Sep 18 doi: 10.1016/j.clp.2018.07.011. PMID: 30396416
Pyriform aperture enlargement in all aspects.
Esen E, Bayar Muluk N, Altintoprak N, Ipci K, Cingi C
J Laryngol Otol 2017 Jun;131(6):476-479. Epub 2017 Feb 27 doi: 10.1017/S0022215117000391. PMID: 28238296
Obstructive sleep apnea in infants.
Katz ES, Mitchell RB, D'Ambrosio CM
Am J Respir Crit Care Med 2012 Apr 15;185(8):805-16. Epub 2011 Dec 1 doi: 10.1164/rccm.201108-1455CI. PMID: 22135346Free PMC Article
Congenital nasal pyriform aperture stenosis: a report of 10 cases and literature review.
Visvanathan V, Wynne DM
Int J Pediatr Otorhinolaryngol 2012 Jan;76(1):28-30. Epub 2011 Oct 22 doi: 10.1016/j.ijporl.2011.09.016. PMID: 22024577
Congenital nasal pyriform aperture stenosis.
Johnson PJ, Rydlund K, Hollins RR
Plast Reconstr Surg 1999 May;103(6):1696-9. doi: 10.1097/00006534-199905060-00019. PMID: 10323705

Clinical prediction guides

Comparison of Surgical Techniques for the Treatment of Congenital Nasal Pyriform Aperture Stenosis: A Systematic Review.
Rosi-Schumacher M, DiNardo LA, Reese AD, Gupta S, Nagy RE, Chakraborty S, Carr MM
Ann Otol Rhinol Laryngol 2024 Jul;133(7):639-646. Epub 2024 Mar 28 doi: 10.1177/00034894241242179. PMID: 38545892
Congenital nasal pyriform aperture stenosis: Analysis of twenty cases at a single institution.
Shah GB, Ordemann A, Daram S, Roman E, Booth T, Johnson R, Xi Y, Mitchell R
Int J Pediatr Otorhinolaryngol 2019 Nov;126:109608. Epub 2019 Jul 26 doi: 10.1016/j.ijporl.2019.109608. PMID: 31374389
Congenital nasal obstruction in infants: A retrospective study and literature review.
Patel VA, Carr MM
Int J Pediatr Otorhinolaryngol 2017 Aug;99:78-84. Epub 2017 May 30 doi: 10.1016/j.ijporl.2017.05.023. PMID: 28688570
The natural course of congenital nasal pyriform aperture stenosis.
Lin KL, Lee KS, Yang CC, Hsieh LC, Su CH, Sun FJ
Laryngoscope 2016 Oct;126(10):2399-402. Epub 2016 Feb 8 doi: 10.1002/lary.25873. PMID: 26853084
Congenital nasal pyriform aperture stenosis 5.7 mm or less is associated with surgical intervention: A pooled case series.
Wormald R, Hinton-Bayre A, Bumbak P, Vijayasekaran S
Int J Pediatr Otorhinolaryngol 2015 Nov;79(11):1802-5. Epub 2015 Jul 28 doi: 10.1016/j.ijporl.2015.07.026. PMID: 26318025

Recent systematic reviews

Comparison of Surgical Techniques for the Treatment of Congenital Nasal Pyriform Aperture Stenosis: A Systematic Review.
Rosi-Schumacher M, DiNardo LA, Reese AD, Gupta S, Nagy RE, Chakraborty S, Carr MM
Ann Otol Rhinol Laryngol 2024 Jul;133(7):639-646. Epub 2024 Mar 28 doi: 10.1177/00034894241242179. PMID: 38545892
Patient selection in congenital pyriform aperture stenosis repair - 14 year experience and systematic review of literature.
Gonik NJ, Cheng J, Lesser M, Shikowitz MJ, Smith LP
Int J Pediatr Otorhinolaryngol 2015 Feb;79(2):235-9. Epub 2014 Dec 22 doi: 10.1016/j.ijporl.2014.12.016. PMID: 25575426

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