ABSTRACT
Congenital nasal pyriform aperture stenosis (CNPAS) is a rare anomaly causing respiratory distress in newborns. While the primary surgical technique is well established, the timing of the removal of the stents and the management of restenosis remain a matter of debate. We report a case of a female newborn affected by CNPAS with the recurrence of respiratory distress after primary surgery due to the early removal of nasal stents, causing an overgrowth of granulation tissue. This report notes that restenosis was successfully managed by repeating the procedure over a 14-day period, with soft polyvinyl chloride uncuffed tracheal tubes acting as nasal stents.
Subject(s)
Nasal Cavity/surgery , Nasal Obstruction/congenital , Nasal Obstruction/surgery , Stents , Constriction, Pathologic/congenital , Constriction, Pathologic/diagnostic imaging , Constriction, Pathologic/pathology , Constriction, Pathologic/surgery , Endoscopy , Female , Humans , Imaging, Three-Dimensional , Infant, Newborn , Nasal Cavity/diagnostic imaging , Nasal Cavity/pathology , Nasal Obstruction/diagnostic imaging , Nasal Obstruction/pathology , Recurrence , Respiratory Distress Syndrome, Newborn/etiology , Tomography, X-Ray ComputedABSTRACT
BACKGROUND: Sphenoid sinus lesions are rare entities, occurring in 2 - 3% out of all paranasal sinus lesions. Isolated oculomotor nerve palsy due to acute sphenoid sinusitis is very rare, with only few cases reported in literature. METHODS: Retrospective report about a case of isolated acute sphenoid sinusitis in a child with a left-sided third cranial nerve paralysis as the only sign at presentation. RESULTS: Isolated oculomotor nerve palsy can be the initial sign of an isolated acute sphenoid sinusitis in children and it requires a high index of suspicion in order to avoid a delay in diagnosis. CONCLUSIONS: Magnetic resonance imaging should be promptly performed. Functional endoscopic sinus surgery represents the treatment of choice in order to restore sinus drainage and avoid further intracranial or ocular complications. The need of serial postoperative debridement under general anesthesia should be adequately scheduled and previously discussed with parents.