{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T12:38:43Z","timestamp":1778503123125,"version":"3.51.4"},"reference-count":19,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,9,5]],"date-time":"2024-09-05T00:00:00Z","timestamp":1725494400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Evaluate the management options for congenital nasal pyriform aperture stenosis (CNPAS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Case series.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Tertiary referral children's hospital.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The medical records of CNPAS patients managed from January 2015 to 2023 were reviewed for medical history, management, and outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifteen patients met inclusion criteria. Six patients (40.0%) had a central mega incisor and 4 (26.7%) had holoprosencephaly. Three (20%) patients were managed with medications alone. Mean PA width was similar between patients managed medically versus those managed surgically (mean width 6.2\u2009\u00b1\u20090.15\u2009mm vs 6.1\u2009\u00b1\u20090.38\u2009mm). Median age at first procedure was 50 (range 8\u2010263) days. Seven (46.7%) underwent an initial balloon nasal dilation and 5 (33.3%) underwent an open sublabial repair. Operative time was lower in the balloon dilation group (mean 27 vs 104\u2009minutes). Five patients had a single balloon dilation and 2 required revision procedures: 1 underwent a second balloon dilation, and 1 patient underwent a subsequent open sublabial procedure. Four patients with an initial open sublabial approach returned to the operating room for nasal balloon dilation or debridement due to nasal synechiae.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>There has been general shift towards minimally invasive surgery. In our series, 8 (53.3%) patients were managed successfully with medical therapy or a single nasal balloon dilation procedure. Of those who underwent an open surgical repair, most (4\/5) required a revision procedure due to synechiae. Given the relative success and lower operative time of balloon dilation, this option should be considered in the management algorithm for CNPAS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>4.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ohn.968","type":"journal-article","created":{"date-parts":[[2024,9,5]],"date-time":"2024-09-05T04:55:27Z","timestamp":1725512127000},"page":"629-634","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Congenital Pyriform Aperture Stenosis: Not All Patients Require Open Repair"],"prefix":"10.1002","volume":"172","author":[{"given":"Eelam","family":"Adil","sequence":"first","affiliation":[{"name":"Department of Otolaryngology and Communication Enhancement Boston Children's Hospital Boston Massachusetts USA"},{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Harvard Medical School Boston Massachusetts 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nasal pyriform aperture stenosis: successful management of restenosis after primary surgery by stent placement","volume":"101","author":"Botti C","year":"2020","journal-title":"Ear Nose Throat J"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2014.53"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13052-021-01124-2"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2023.111654"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s004310050763"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348941312201001"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348940111000113"}],"container-title":["Otolaryngology\u2013Head and Neck 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