The Role of the Inferior Turbinates in Congenital Pyriform Aperture Stenosis

Abstract

Objective:

To investigate whether inferior turbinate position contributes to nasal obstruction in congenital nasal pyriform aperture stenosis (CNPAS) by characterizing the position of the inferior turbinates compared to healthy newborns via computed tomography (CT).

Methods:

In this retrospective case-control study, CT scans of 12 CNPAS newborns that were part of their diagnostic workup and the CT scans of 31 control newborns obtained for unrelated clinical reasons were analyzed. Measurements included aperture width, distance between the inferior turbinates, the anterior nasal wall as well as the mid-nasal and choanal widths.

Results:

The CNPAS cases consistently showed medialized inferior turbinates in the anterior nasal cavities. The mean distance between the inferior turbinates was significantly narrower (3.98 ± 0.63 mm) than the distance between the maxillary processes of the pyriform aperture (4.94 ± 0.88 mm) in the CNPAS infants as compared to 8.48 ± 1.12 and 11.95 ± 1.13 mm respectively in the controls (P < .001 for both comparisons). The average ratio of the inferior turbinate distance to the lateral nasal cavity wall width was 0.35 ± 0.08 in the CNPAS versus 0.50 ± 0.05 in the controls (P < .001). In all the CNPAS cases, the mid-nasal width was narrower than the choanal width (P < .001), whereas in the control group, the mid-nasal width was wider (P < .001).

Conclusion:

These results indicate that the inferior turbinates tend to be medialized in newborns with CNPAS. This suggests that the inferior turbinates may be a significant factor in infants with CNPAS, thus pointing to the potential value of their surgical reduction. Therefore, measuring the inferior turbinate width can provide additional insight into the severity of nasal obstruction and assist in determining the appropriate management strategy.