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- Title
Comparison of Surgical Techniques for the Treatment of Congenital Nasal Pyriform Aperture Stenosis: A Systematic Review.
- Authors
Rosi-Schumacher, Mattie; DiNardo, Lauren A.; Reese, Alyssa D.; Gupta, Soumya; Nagy, Ryan E.; Chakraborty, Saptarshi; Carr, Michele M.
- Abstract
Introduction: Congenital nasal pyriform aperture stenosis (CNPAS) is a rare condition that results in neonatal respiratory difficulty. The purpose of this systematic review was to compare surgical outcomes of drilling versus dilation techniques in the treatment of CNPAS. Methods: Pubmed, Embase, and Cochrane Clinical Trials databases were searched for terms "congenital nasal pyriform aperture stenosis" or "pyriform aperture stenosis" from 2010 to 2021. Twenty-five studies were included that evaluated pediatric patients treated surgically for CNPAS with available outcomes data including complications, revisions, and length of stay. Results: A total of 51 patients with CNPAS were pooled from included studies. The median age was 29 days, 56.9% were female, and 54.9% were born full-term. The median pyriform aperture width before surgery was 5.00 mm (IQR = 4.10, 6.45). Forty (78.4%) patients underwent sublabial drilling, while 6 had a dilation procedure performed with hegar cervical dilators, 2 had a balloon dilation, and 3 were dilated with either an acrylic device, endotracheal tube, or bougie. There were no post-operative complications for 76.5% of patients, while a second surgery was required in 9 (17.6%) patients. The median length of stay was 11 days (IQR = 4, 26). No statistically significant difference was observed between sublabial drilling and surgical dilation techniques with respect to complications, need for revision surgery, or length of stay. Conclusion: Current literature is insufficient to determine if drilling or dilation is more effective in the treatment of CNPAS.
- Subjects
NASAL surgery; NASAL cavity; MEDICAL information storage &; retrieval systems; STENOSIS; RESPIRATORY obstructions; CATHETERIZATION; TREATMENT effectiveness; DESCRIPTIVE statistics; SYSTEMATIC reviews; MEDLINE; DURATION of pregnancy; MEDICAL databases; ONLINE information services; COMPARATIVE studies; LENGTH of stay in hospitals
- Publication
Annals of Otology, Rhinology & Laryngology, 2024, Vol 133, Issue 7, p639
- ISSN
0003-4894
- Publication type
Article
- DOI
10.1177/00034894241242179