Wormald R, Hinton-Bayre A, Bumbak P, Vijayasekaran S
Department of Otolaryngology-Head and Neck Surgery, Princess Margaret Hospital for Children, Perth, WA, Australia.
Department of Otolaryngology-Head and Neck Surgery, Princess Margaret Hospital for Children, Perth, WA, Australia.
Int J Pediatr Otorhinolaryngol. 2015 Nov;79(11):1802-5. doi: 10.1016/j.ijporl.2015.07.026. Epub 2015 Jul 28.
Congenital nasal pyriform aperture stenosis (CNPAS) is a rare cause of upper airway obstruction in the newborn. CNPAS is diagnosed clinically and confirmed with CT scanning. Early diagnosis and management is essential for this potentially life-threatening condition. Patients can be managed conservatively or surgically. Surgical treatment is usually reserved for those patients that fail conservative treatment. Our objective was to provide a radiologically-measured pyriform aperture (PA) width that predicts the need for surgical intervention.
This study was a retrospective chart review of patients treated in a tertiary paediatric hospital as well as a review of the literature. Outcome measures were defined as surgical or conservative intervention for the management of congenital pyriform aperture stenosis.
Data from 26 individual patients (7 patients from our own case series and 19 patients from previously published reports) was analysed to calculate those patients requiring surgical intervention.
A PA width of less than 5.7 mm in a neonate is 88% sensitive and specific in predicting that a patient will require surgical intervention.
先天性鼻梨状孔狭窄（CNPAS）是新生儿上呼吸道梗阻的罕见原因。CNPAS通过临床诊断并经CT扫描确诊。对于这种可能危及生命的疾病，早期诊断和治疗至关重要。患者可采用保守治疗或手术治疗。手术治疗通常适用于保守治疗失败的患者。我们的目的是提供一种通过影像学测量的梨状孔（PA）宽度，以预测手术干预的必要性。
本研究是对一家三级儿科医院治疗的患者进行回顾性病历审查以及文献综述。结局指标定义为先天性梨状孔狭窄治疗的手术或保守干预。
分析了26例个体患者的数据（7例来自我们自己的病例系列，19例来自先前发表的报告），以计算那些需要手术干预的患者。
新生儿PA宽度小于5.7 mm对预测患者需要手术干预的敏感性和特异性为88%。
