Pyriform aperture stenosis

Pyriform aperture stenosis refers to narrowing of the pyriform aperture and results from early fusion and hypertrophy of the medial nasal processes.

Pyriform aperture stenosis is a rare cause of airway obstruction, and its prevalence is unknown.

HRCT is the imaging modality of choice. It is performed in planes angled along the hard palate with a section thickness of 1-1.5 mm and should include the maxillary spines. 

Imaging features of pyriform aperture stenosis include a shelf of tissue extending across the nostrils just inside the nares, inward bowing of the maxillary spines, and narrowing of the pyriform aperture.

No standard measurements exist for the normal pyriform aperture; consequently, the diagnosis of aperture stenosis may be difficult.

Associated intracranial anomalies can be excluded in infants with MR imaging or ultrasonography.

Treatment of mild cases of pyriform aperture stenosis includes administration of decongestants, which allows time for normal nasal growth. Severe cases may require surgical reconstruction with stent placement, sublabial resection of the anteromedial maxilla, or reconstruction of the anterior nasal passages

Possible consideration on axial CT images include

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Article information

rID: 21314
System: Head & Neck
Synonyms or Alternate Spellings:
  • Pyriform aperture stenoses
  • Stenosis of the pyriform aperture
  • Congenital nasal pyriform aperture stenosis (CNPAS)
  • Congenital nasal pyriform aperture stenosis

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