Pyriform Aperture Stenosis: A Novel Approach to Stenting.

OBJECTIVES: Congenital nasal pyriform aperture stenosis (CNPAS) is one of several causes of neonatal respiratory distress. Congenital nasal pyriform aperture stenosis can be diagnosed by clinical presentation and evaluated by computed tomography for degree of stenosis. Surgical management of indicated cases involves drillout of pyriform aperture with placement of stents. The following case presents a novel approach to choice of stent in these patients.

CASE PRESENTATION: We report the case of an infant diagnosed with CNPAS who underwent surgical correction at 9 days of life, with placement of mometasone fuorate stents.

DISCUSSION: Although relatively uncommon, CNPAS is a type of airway obstruction that causes cyclic cyanosis and failure to thrive in affected infants. If uncorrected medically, surgical interventions can successfully restore patency of the nasal cavity. While traditional stents can result in undesired complications, the use of mometasone fuorate stents presents an alternative without the typically associated risks.

CONCLUSION: The use of mometasone fuorate stents may be a helpful option for otolaryngologists looking for the potential to avoid restenosis, plugging, and nasal alar necrosis in patients undergoing surgical treatment of CNPAS.