Jonniaux E, Brihaye P, Bernheim N, Mansbach A L
University Children's Hospital Reine Fabiola Brussels Free University.
B-ENT. 2006;2(1):31-3.
Apertura pyriformis stenosis in the newborn. Respiratory distress in the newborn can have a variety of aetiologies, the best known of which are cardiac and pulmonary diseases. Major nasal airway obstruction is probably often overlooked when acute desaturation of the neonate requires reanimation procedures, although it is well established that the baby is an obligate nose breather at birth. Nasal airway stenosis or atresia could account for a number of unexplained deaths in the delivery room. In the differential diagnosis of major nasal airway obstruction in the newborn, choanal atresia is by far the most common aetiology. However, a few cases of pyriform aperture stenosis have been reported. One child presenting this pathology was recently treated at the Brussels University Children's Hospital. Unexpectedly, the baby survived until 3 months without any medical support but had severe feeding problems. The diagnosis was confirmed by naso-sinusal CT scan. Surgery was performed at 4 months through an unusual endonasal approach which seems to be less traumatic than the classical sublabial approach. The post-operative course was satisfactory. The 9-month-old patient does not now show residual breathing problems. The presentation will focus on this unusual case.
新生儿梨状孔狭窄。新生儿呼吸窘迫可有多种病因，其中最常见的是心脏和肺部疾病。当新生儿急性低氧血症需要复苏时，主要鼻气道阻塞可能常被忽视，尽管新生儿出生时是绝对的鼻呼吸者这一点已得到充分证实。鼻气道狭窄或闭锁可能是产房内一些不明原因死亡的原因。在新生儿主要鼻气道阻塞的鉴别诊断中，后鼻孔闭锁是迄今为止最常见的病因。然而，也有少数梨状孔狭窄的病例报道。最近，布鲁塞尔大学儿童医院治疗了一名患有这种疾病的儿童。出乎意料的是，这个婴儿在没有任何医疗支持的情况下存活到了3个月，但有严重的喂养问题。鼻窦CT扫描确诊了病情。4个月时通过一种不寻常的鼻内入路进行了手术，这种入路似乎比传统的唇下入路创伤更小。术后过程令人满意。现在，这名9个月大的患者没有呼吸问题残留。本次报告将聚焦于这一罕见病例。
