Skip to main content

Advertisement

SpringerLink
Log in

Congenital nasal obstruction: clinical and radiologic review

  • Review
  • Published:
European Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Congenital nasal obstruction can result in neonatal respiratory distress because neonates are obligate nasal breathers. Therefore, all physicians who deal with infants should be familiar with the structural abnormalities, masses, and syndromes that cause nasal obstruction, so that appropriate work-up and treatment can be promptly initiated. This paper reviews the embryology of the nasal passage and then continues with the different causes of nasal obstruction. Special attention is paid to the presentation, physical exam findings, and imaging modality of choice.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10

Similar content being viewed by others

Abbreviations

CT:

Computerized tomography

PAS:

Pyriform aperature stenosis

MRI:

Magnetic resonance imaging

CNS:

Central nervous system

CSF:

Cerebrospinal fluid

AVM:

Arteriovenous malformation

References

  1. Arlis H, Ward RF (1992) Congenital nasal pyriform aperture stenosis. Isolated abnormality vs developmental field defect. Arch Otolaryngol Head Neck Surg 118(9):989–991

    Article  PubMed  CAS  Google Scholar 

  2. Belden CJ, Mancuso AA, Schmalfuss IM (1999) CT features of congenital nasal piriform aperture stenosis: initial experience. Radiology 213:495–501

    PubMed  CAS  Google Scholar 

  3. Brown OE, Pownell P, Manning SC (1996) Choanal atresia: a new anatomic classification and clinical management applications. Laryngoscope 106:97–101

    Article  PubMed  CAS  Google Scholar 

  4. Burrow TA, Saal HM, de Alarcon A, Martin LJ, Cotton RT, Hopkin RJ (2009) Characterization of congenital anomalies in individuals with choanal atresia. Arch Otolaryngol Head Neck Surg 135(6):543–547

    Article  PubMed  Google Scholar 

  5. Coppit GL 3rd, Perkins JA, Manning SC (2000) Nasopharyngeal teratomas and dermoids: a review of the literature and case series. Int J Pediatr Otorhinolaryngol 52(3):219–227

    Article  PubMed  Google Scholar 

  6. De Moura CP, Andrade D, Cunha LM, Tavares MJ, Cunha MJ, Vaz P, Barros H, Pueschel SM, Clemente MP (2008) Down syndrome: otolaryngological effects of rapid maxillary expansion. J Laryngol Otol 122(12):1318–1324

    Article  PubMed  Google Scholar 

  7. Denoyelle F, Ducroz V, Roger G, Garabedian EN (1997) Nasal dermoid sinus cysts in children. Laryngoscope 107(6):795–800

    Article  PubMed  CAS  Google Scholar 

  8. Gray LP (1978) Deviated nasal septum. Incidence and etiology. Ann Otol Rhinol Laryngol Supp 87(3 Pt 3 Suppl 50):3–20

    CAS  Google Scholar 

  9. Guilmin-Crépon S, Garel C, Baumann C et al (2006) High proportion of pituitary abnormalities and other congenital defects in children with congenital nasal pyriform aperture stenosis. Pediatr Res 60(4):478–484

    Article  PubMed  Google Scholar 

  10. Hedlund G (2006) Congenital frontonasal masses: developmental anatomy, malformations, and MR imaging. Pediatr Radiol 36(7):647–662

    Article  PubMed  Google Scholar 

  11. Hengerer AS, Brickman TM, Jeyakumar A (2008) Choanal atresia: embryologic analysis and evolution of treatment, a 30-year experience. Laryngoscope 118(5):862–866

    Article  PubMed  Google Scholar 

  12. Hepler KM, Woodson GE, Kearns DB (1995) Respiratory distress in the neonate. Sequela of a congenital dacryocystocele. Arch Otolaryngol Head Neck Surg 121(12):1423–1425

    Article  PubMed  CAS  Google Scholar 

  13. Huth ME, Heimgartner S, Schnyder I, Caversaccio MD (2008) Teratoma of the nasal septum in a neonate: an endoscopic approach. J Pediatr Surg 43(11):2102–2105

    Article  PubMed  Google Scholar 

  14. Jacqueline EJ, Young E, Heier L (1998) Congenital bony nasal cavity deformities. Am J Rhinol 12(2):81–86

    Article  Google Scholar 

  15. Leclerc JE, Fearon B (1987) Choanal atresia and associated anomalies. Int J Pediatr Otorhinolaryngol 13(3):265–272

    Article  PubMed  CAS  Google Scholar 

  16. Lo LJ, Chen YR (1999) Airway obstruction in severe syndromic craniosynostosis. Ann Plast Surg 43(3):258–264

    Article  PubMed  CAS  Google Scholar 

  17. MacEwen CJ, Young JD (1991) Epiphora during the first year of life. Eye 5:596–600

    Article  PubMed  Google Scholar 

  18. Macfarlane R, Rutka JT, Armstrong D et al (1995) Encephaloceles of the anterior cranial fossa. Pediatr Neurosurg 23(3):148–158

    Article  PubMed  CAS  Google Scholar 

  19. Ma KH, Cheung KL (2006) Nasal glioma. Hong Kong Med J 12(6):477–479

    PubMed  CAS  Google Scholar 

  20. Nathan CO, Seid AB (1997) Neonatal rhinitis. Int J Pediatr Otorhinolaryngol 39(1):59–65

    Article  PubMed  CAS  Google Scholar 

  21. Neskey D, Eloy JA, Casiano RR (2009) Nasal, septal, and turbinate anatomy and embryology. Otolaryngol Clin North Am 42(2):193–205

    Article  PubMed  Google Scholar 

  22. Raghavan U, Fuad F, Gibbin KP (2004) Congenital midnasal stenosis in an infant. Int J Pediatr Otorhinolaryngol 68(6):823–825

    Article  PubMed  CAS  Google Scholar 

  23. Shetty SC, Gupta S, Cherian M, Chary G, Shariff S (2000) Mature teratoma of the nasal vestibule: a case report. Ear Nose Throat J 79(8):620–623

    PubMed  CAS  Google Scholar 

  24. Tolley NS, Ford G, Commins D (1992) The management of neonatal rhinitis. Int J Pediatr Otorhinolaryngol 24(3):253–260

    Article  PubMed  CAS  Google Scholar 

  25. Van Den Abbeele T, Triglia JM, François M, Narcy P (2001) Congenital nasal pyriform stenosis: diagnosis and management of 20 cases. Ann Otol Rhinol Laryngol 110:70–75

    Google Scholar 

  26. Zanini SA, Viterbo F, Parro FH (1996) Apert’s syndrome: modification in corrective techniques. J Craniofac Surg 7(1):79–81

    Article  PubMed  CAS  Google Scholar 

Download references

Financial disclosures

None.

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Division of Otolaryngology-Head and Neck Surgery, Pennsylvania State University, 500 University Drive, Hershey, PA, 17033, USA

    Eelam Adil, Colin Huntley & Michele Carr

  2. Department of Radiology, Pennsylvania State University, 500 University Drive, Hershey, PA, 17033, USA

    Arabinda Choudhary

  3. Division of Otolaryngology-Head and Neck Surgery, Pennsylvania State University, Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA, 17033, USA

    Eelam Adil

Authors
  1. Eelam Adil
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Colin Huntley
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Arabinda Choudhary
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Michele Carr
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Eelam Adil.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Adil, E., Huntley, C., Choudhary, A. et al. Congenital nasal obstruction: clinical and radiologic review. Eur J Pediatr 171, 641–650 (2012). https://doi.org/10.1007/s00431-011-1591-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00431-011-1591-6

Keywords

Search

Navigation