Congenital Bony Nasal Cavity Deformities

1998 ◽  
Vol 12 (2) ◽  
pp. 81-86 ◽  
Author(s):  
Jacqueline E. Jones ◽  
Eytan Young ◽  
Linda Heier
Keyword(s):  
Soft Tissue ◽  
Respiratory Distress ◽  
Airway Obstruction ◽  
Nasal Cavity ◽  
Congenital Anomalies ◽  
Clinical Management ◽  
Choanal Atresia ◽  
Anatomical Features ◽  
Tissue Edema ◽  
Pyriform Aperture

Although the most common form of nasal obstruction in neonates is soft tissue edema, congenital bony nasal deformities are being recognized as an important cause of newborn airway obstruction. In addition to the well described choanal atresia, CT imaging of the newborn in respiratory distress reveals two other forms of bony nasal cavity deformities: nasal pyriform aperture stenosis and nasal cavity stenosis. All of the three types of bony nasal cavity deformities have characteristic anatomical features, are associated with distinctive congenital anomalies, and are postulated to have differing embryological causes. Five patients with congenital bony nasal cavity deformities are presented. These cases illustrate the clinical and radiological presentation of varied types of congenital nasal cavity obstruction as well as the criteria used to guide clinical management.

scholarly journals Penanganan meningosil dan atresia koana bilateral

2013 ◽  
Vol 43 (1) ◽  
Author(s):  
Muhammad Fadjar Perkasa
Keyword(s):  
Soft Tissue ◽  
Nasal Cavity ◽  
Congenital Anomalies ◽  
Choanal Atresia ◽  
Emergency Situation ◽  
Operating Theatre ◽  
Careful Examination ◽  
Baby Girl

Latar belakang: Atresia koana adalah tertutupnya satu atau kedua posterior kavum nasi oleh membranabnormal atau tulang. Hal ini dapat terjadi bersamaan dengan kelainan kongenital lainnya. Atresia koanabilateral menyebabkan keadaan darurat pada saat kelahiran. Angka kejadian atresia koana adalah 1 kasus per5000 - 8000 kelahiran. Kejadian pada perempuan dua kali lebih banyak daripada laki-laki. Tujuan: Membahassatu kasus bayi dengan atresia koana bilateral yang didiagnosis di ruang operasi, yang tidak terdeteksisebelumnya karena adanya meningosil. Kasus: Bayi perempuan 16 hari dengan meningosil dan atresia koanabilateral. Penatalaksanaan: Pasien menjalani koanoplasti transnasal dan pemasangan stent. Pasien sembuhdengan baik. Kesimpulan: Atresia koana dapat terjadi bersama dengan kelainan kongenital lainnya, sehinggamemerlukan pemeriksaan yang teliti karena atresia koana bilateral menyebabkan keadaan darurat danmemerlukan penanganan segera.Kata kunci : atresia koana, koanoplasti, stent.ABSTRACTBackground: Choanal atresia is a condition where one or both posterior nasal cavity is blocked byabnormal bony or soft tissue. This condition can occur concomitant with other congenital anomalies. Bilateralchoanal atresia causes emergency situation at birth. The incidence of choanal atresia is one case per 5000-8000births and are twice as much in females. Purpose: To discuss a case of bilateral choanal atresia which wasdiagnosed in the operating theatre, undetected previously because of the meningocele. Case: A baby girl 16 daysold with meningocele and bilateral choanal atresia. Management: The patient underwent transnasalchoanoplasty and stenting. The result was satisfactory. Conclusion: Choanal atresia can occure with othercongenital abnormalities, so careful examination is mandatory as bilateral choanal atresia needs promptmanagement.Keywords : choanal atresia, choanoplasty, stent

scholarly journals CHOANAL ATRESIA

2018 ◽  
Vol 21 (04) ◽  
pp. 816-819
Author(s):  
Adil Ayub ◽  
Ayesha Ayub ◽  
Ayub-ur- Rehman
Keyword(s):  
Nasal Cavity ◽  
Congenital Malformation ◽  
Diagnostic Tool ◽  
Congenital Anomalies ◽  
Clinical Course ◽  
Choanal Atresia ◽  
Surgical Approaches ◽  
Prompt Treatment ◽  
The Past ◽  
Important Diagnostic Tool

Choanal atresia (CA) is a rare, congenital malformation resulting as a failure incommunication between the posterior nasal cavity and the nasopharynx. The clinical course isoften asymptomatic in unilateral CA leading to higher rates of misdiagnosis, in comparison tobilateral CA, which manifests itself as a surgical emergency at birth. Most cases present asisolated malformations, but it may also be associated with other congenital anomalies in 20-50%of cases. Currently, the most important diagnostic tool for CA is computerized tomography (CT)and confirmatory diagnosis is usually achieved with the help of nasoendoscopic examination.Although, different surgical approaches have been used in the past, transnasal endoscopicrepair is currently preferred over others. Herein, we describe our experience of three cases andshare our simple stentless endoscopic technique, to facilitate physicians working in low facilityunits for a timely diagnosis and prompt treatment.

Severe Rhinorrhea and Respiratory Distress in a Neonate Exposed to Fluphenazine Hydrochloride Prenatally

1996 ◽  
Vol 30 (1) ◽  
pp. 35-37 ◽  
Author(s):  
Shanta P Nath ◽  
Debra A Miller ◽  
Jonathan K Muraskas
Keyword(s):  
Differential Diagnosis ◽  
Respiratory Distress ◽  
Airway Obstruction ◽  
Congenital Syphilis ◽  
Choanal Atresia ◽  
Upper Airway ◽  
In Utero ◽  
Upper Airway Obstruction ◽  
Case Summary ◽  
Causative Factors

OBJECTIVE: To report a case of respiratory distress with severe rhinorrhea in a newborn exposed prenatally to fluphenazine hydrochloride. CASE SUMMARY: The safety of phenothiazines during pregnancy and the effect on the fetus and newborn are not well known. We describe a newborn who had severe rhinorrhea, vomiting, and respiratory distress after being exposed in utero to fluphenazine hydrochloride. Sepsis, choanal atresia, and congenital syphilis were excluded as causative factors for rhinorrhea. The rhinorrhea and upper airway obstruction responded to treatment with pseudoephedrine. CONCLUSIONS: Severe rhinorrhea, vomiting, and respiratory distress that occurred in this infant have not been reported previously following prenatal fluphenazine hydrochloride exposure. Awareness of this problem would be helpful to clinicians and should be considered in the differential diagnosis of rhinorrhea in newborns.

scholarly journals Age-related description of the posterior structures of the nasal cavity in children

2020 ◽  
Vol 9 (3) ◽  
pp. 9-15
Author(s):  
I. V. Gaivoronskii ◽  
M. V. Markeeva ◽  
O. Yu. Aleshkina ◽  
N. V. Tarasova
Keyword(s):  
Nasal Cavity ◽  
Anterior Part ◽  
Treatment Options ◽  
Choanal Atresia ◽  
Posterior Part ◽  
Surgical Access ◽  
Age Related ◽  
Morphometric Features ◽  
Infancy And Early Childhood ◽  
Pyriform Aperture

The aim of the study was to describe morphometric characteristics of the posterior parts of the nasal cavity in different periods of childhood and to specify the age-related norm for improving surgical treatment options of choanal atresia and providing an optimal access to the anterior part of the skull base. Material and methods. The study included 87 children aged 1-21 who were exposed to craniometry of the nasal cavity structures. Results. The age-related variability of the linear dimensions and shape of the choanae, their relationship with the dimensions of the pyriform aperture and the height of the nasal cavity in the posterior part were defined in the study. The increase in the height of the choanae and the height of the nasal cavity at the back starts from 2– 3 years of age, and the width – from 8–12 years of age. The height and width of the pyriform aperture are equal to the age of 8–12; these parameters increase in older children's groups with a predominance of the height over the width. The height of the nasal cavity at the back increases in all age periods. The growth of the studied structures of the nasal cavity is completed by adolescence. In infancy, the height of the choanae is less than the height of the nasal cavity at the back by 45%, and less than the height of the pyriform aperture by 20%; in adolescence, these ratios are 42% and 23%, respectively. In infancy the choanal width is less than the width of the pyriform aperture by 49%, and in adolescence – by 40%. In infancy and early childhood, the choanae are typically small in height and width. Their shape is round in 25% of cases, however, ovoid shape is also found. The height and width of the pyriform-shaped aperture at these age periods are similar and do not exceed 17–18 mm; the height of the nasal cavity at the back is 25–27 mm. Conclusion. The authors have described age-related morphometric features of the posterior structures of the nasal cavity. These features should be taken into account by otorhinolaryngologists and neurosurgeons when planning endoscopic intranasal surgical access in children. The younger the child is, the more difficult it is to perform a surgery due to the significant restriction of the access resulted from the small size of the piriform opening and the nasal cavity, and the obstinacy of the nasal septum. When performing choanotomy for atresia, it is necessary to form the choana comparing it in shape and size with the age-related norm

scholarly journals Newborn Nasal Obstruction due to Congenital Nasal Pyriform Aperture Stenosis

2016 ◽  
Vol 7 (1) ◽  
pp. ar.2016.7.0146 ◽  
Author(s):  
Thiago L. I. Serrano ◽  
Leopoldo Pfeilsticker ◽  
Vanessa Silva ◽  
Igor Hazboun ◽  
Jorge Paschoal ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Respiratory Distress ◽  
Nasal Cavity ◽  
Nasal Obstruction ◽  
Treatment Strategies ◽  
Rare Condition ◽  
Surgical Correction ◽  
Severe Respiratory Distress ◽  
First Case ◽  
Pyriform Aperture

Introduction Nasal obstruction is an important condition that can lead to severe respiratory distress in newborns. There are several differential diagnoses, and one of them is congenital nasal pyriform aperture stenosis (CNPAS). CNPAS is a rare case of respiratory distress caused by excessive growth of the nasal process of the maxilla and leads to narrowing of the anterior third of the nasal cavity. Diagnosis, associated anomalies, and treatment strategies are reviewed by the following presentation of two cases. Case Presentation We report two cases of infants diagnosed with CNPAS. The patients in the first case had no concomitant comorbidities, and the outcome was successful after surgical correction of stenosis. The patient in the second case had an associated holoprosencephaly, and although surgical correction and nasal cavity patency, the patient remains dependent on tracheostomy due to dysphagia and neurologic impairment. Discussion Airway obstruction affects 1 in 5000 children, and CNPAS is a diagnosis frequently forgotten and even unknown to neonatal and pediatric intensivists. Newborns are obligate nasal breathers, and, nasal obstruction, therefore, can lead to severe respiratory distress. CNPAS is not only rare but, many times, is not easily recognized. It is important to bear in mind the diagnostic criteria when evaluating infants with nasal obstruction. Conservative treatment should be prioritized, but surgical treatment is required in severe cases with failure to thrive and persistent respiratory distress. Respiratory distress and dysphagia may persist to some degree despite correction of the stenotic pyriform aperture due to associated narrowing of the entire nasal cavity and association with other anomalies. Final Comments CNPAS is a rare condition and may be lethal in newborns. Differential diagnosis of nasal obstruction must be remembered to recognize this anomaly, and the otolaryngologist must be familiarized with this condition and its diagnosis. Precise surgical treatment in severe cases have high rates of success in children without other comorbidities.

Respiratory distress in patients with central airway obstruction

2010 ◽  
Vol 26 (2) ◽  
pp. 151-156
Author(s):  
Mohamed Abdel Hamied Regal ◽  
Yasser Ahmed El Ghoneimy ◽  
Yasser Maher Aljehani
Keyword(s):  
Respiratory Distress ◽  
Airway Obstruction ◽  
Central Airway Obstruction ◽  
Central Airway

scholarly journals A national study of choanal atresia in tertiary care centers in Canada – part I: clinical presentation

2021 ◽  
Vol 50 (1) ◽  
Author(s):  
Josee Paradis ◽  
Agnieszka Dzioba ◽  
Hamdy El-Hakim ◽  
Paul Hong ◽  
Frederick K. Kozak ◽  
...  
Keyword(s):  
Respiratory Distress ◽  
Clinical Presentation ◽  
Tertiary Care ◽  
Choanal Atresia ◽  
Case Series ◽  
Retrospective Chart Review ◽  
National Study ◽  
Feeding Difficulties ◽  
Presenting Symptoms ◽  
Tertiary Care Centers

Abstract Background To evaluate the clinical presentation of choanal atresia (CA) in tertiary centers across Canada. Methods Multi-centre case series involving six tertiary care pediatric hospitals across Canada. Retrospective chart review of patients born between 1980 and 2010 diagnosed with CA at a participating center. Results The health charts of 215 patients (59.6% female) with CA were reviewed and included in this study. The mean age of patients at time of CA presentation was 0.4 months (range 0.1 to 7.2 months) for bilateral CA and 37.8 months (range 0.1 to 164.1 months) for unilateral cases. The most common presenting symptoms for bilateral CA in decreasing order were respiratory distress (96.4%), feeding difficulties (68.2%), and rhinorrhea (65.5%), and for unilateral cases in decreasing order were rhinorrhea (92.0%), feeding difficulties (24.7%), and respiratory distress (18.0%). For the majority of patients (73.2%), the obstruction comprised mixed bony and membranous tissue, with only 10.5% presenting with a purely membranous obstruction. Familial history of CA was confirmed in only 3.3% of cases. One half of patients with CA presented with one or more associated anomalies and 30.6% had a syndrome. Conclusions The present investigation is the first national multi-institutional study evaluating the clinical presentation of CA over three decades. The present cohort of CA patients presented with a breadth of co-morbidities with highly variable presentations, with bilateral cases being more severely affected than unilateral cases. Further investigation into hereditary linkages to CA development is warranted. Graphical abstract

Transient Soft-Tissue Edema Associated with Implantation of Increasing Doses of rhBMP-2 on an Absorbable Collagen Sponge in an Ectopic Rat Model

2012 ◽  
Vol 94 (20) ◽  
pp. 1845-1852 ◽  
Author(s):  
Hyun W. Bae ◽  
K. Brandon Strenge ◽  
Nomaan Ashraf ◽  
Jeffrey M. Badura ◽  
Steven M. Peckham ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Rat Model ◽  
Collagen Sponge ◽  
Absorbable Collagen Sponge ◽  
Tissue Edema
Sign in / Sign up

Export Citation Format

Share Document