Lee Kuo-Sheng, Yang Cheng-Chien, Huang Jon-Kway, Chen Yu-Chun, Chang Ke-Chang
Department of Otolaryngology-Head and Neck Surgery, Mackay Memorial Hospital, Taipei, Taiwan.
Laryngoscope. 2002 May;112(5):918-21. doi: 10.1097/00005537-200205000-00025.
We described the surgical efficacy of congenital pyriform aperture stenosis by measuring the width of the nasal pyriform aperture with three-dimensional computed tomography.
Six patients with congenital pyriform aperture stenosis accepted surgical intervention. Three-dimensional computed tomography was performed for preoperative and postoperative evaluation of nasal pyriform aperture width. We marked the midpoint between the tip of nasal bone and the anterior nasal spine. The distances between the bilateral nasal processes of the maxilla and between the lateral rims of the pyriform aperture were measured by crossing the midpoint horizontally.
Among the six patients (three male and three female patients), the mean age was 76.2+/-23.9 days. Silicon stents were removed 6 to 7 days after operation. During 9 months of follow-up, there were no cases of restenosis, respiratory failure, or cyanosis. The mean preoperative and postoperative interprocess distances were 4.5+/-0.84 and 8.7+/-1.37 mm, respectively, and data were statistically significant at a confidence level of P <.05. The mean preoperative and postoperative interwall distances were 9.8+/-0.75 and 10.8+/-1.5 mm, respectively.
Congenital pyriform aperture stenosis should be suspected whenever there is both severe nasal obstruction and difficulty in passing a small catheter or nasogastric tube through the anterior nasal valve. Operation is the most extreme treatment, but it is effective for congenital pyriform aperture stenosis. Nasal stenting for 7 days seemed to be adequate. The use of three-dimensional computed tomography to evaluate preoperative and postoperative nasal pyriform aperture is effective and reliable.
通过三维计算机断层扫描测量鼻梨状孔宽度，描述先天性梨状孔狭窄的手术疗效。
6例先天性梨状孔狭窄患者接受手术干预。术前行三维计算机断层扫描以评估鼻梨状孔宽度，术后再次扫描评估。标记鼻骨尖端与前鼻棘之间的中点，通过该中点水平交叉测量上颌双侧鼻突之间以及梨状孔外侧缘之间的距离。
6例患者（3例男性和3例女性），平均年龄为76.2±23.9天。术后6至7天取出硅胶支架。在9个月的随访期间，无再狭窄、呼吸衰竭或发绀病例。术前和术后鼻突间平均距离分别为4.5±0.84和8.7±1.37mm，数据在P<0.05的置信水平上具有统计学意义。术前和术后鼻壁间平均距离分别为9.8±0.75和10.8±1.5mm。
当出现严重鼻塞且难以将小导管或鼻胃管通过前鼻瓣时，应怀疑先天性梨状孔狭窄。手术是最彻底的治疗方法，但对先天性梨状孔狭窄有效。鼻支架置入7天似乎足够。使用三维计算机断层扫描评估术前和术后鼻梨状孔有效且可靠。
