Assessment of Nasal Dimensions at the Pyriform Aperture and Mid-Nose in Neonates and Infants With Nasal Obstruction

Background and Objectives Neonatal nasal obstruction can lead to significant morbidity. We carried out this study to investigate the radiological measurements of nasal dimensions that are correlated with the diagnosis of congenital bony stenosis, and to present a management strategy for neonatal nasal airway obstruction.Subjects and Method A total of 54 patients were included for the study. We conducted CT scans for all the patients to assess the cause of nasal obstruction. Among these patients, 27 individuals had nasal obstruction caused by stenosis at the level of pyriform aperture (PA) or mid-nose (MN), while the remaining 27 experienced nasal obstruction due to different causes. Radiological measurements were conducted and compared between these two groups. Operative data and follow-up information obtained for a period of 6 months were reviewed.Results Patients requiring surgery for the treatment of nasal stenosis exhibited a PA with the average width of 6.2 mm ([SD±1.7]; median [IQR] 6 [5-6.5]), and a MN with the average size of 5.1 mm ([SD±0.9]; median [IQR] 5 [4.4-6]). Infants experiencing nasal obstruction due to other reasons had an average PA measuring at 11.7 mm ([SD±1.9]; median [IQR] 12 [11-13]) and MN at 8.1 ([SD±1.3]; median [IQR] 8.2 [7-9]).Conclusion Clinical, endoscopic, and radiological data together can help determine whether patients with nasal stenosis need surgery. We found that PA stenosis is often associated with MN level stenosis.