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Congenital nasal obstruction in infants: A retrospective study and literature review.

Abstract To identify etiologies of congenital nasal obstruction and describe clinical practice patterns in the evaluation, diagnosis, and treatment of symptomatic infants.
PMID
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Authors

Mayor MeshTerms
Keywords

Airway

Congenital

Infant

Nasal

Obstruction

Pediatric

Journal Title international journal of pediatric otorhinolaryngology
Publication Year Start




PMID- 28688570
OWN - NLM
STAT- In-Process
DA  - 20170709
LR  - 20170709
IS  - 1872-8464 (Electronic)
IS  - 0165-5876 (Linking)
VI  - 99
DP  - 2017 Aug
TI  - Congenital nasal obstruction in infants: A retrospective study and literature
      review.
PG  - 78-84
LID - S0165-5876(17)30242-2 [pii]
LID - 10.1016/j.ijporl.2017.05.023 [doi]
AB  - OBJECTIVES: To identify etiologies of congenital nasal obstruction and describe
      clinical practice patterns in the evaluation, diagnosis, and treatment of
      symptomatic infants. METHODS: An electronic chart review from 1/1/2006-10/1/2016 
      for all patients with a diagnosis of nasal obstruction within the first six
      months of life using ICD-9 and 10 codes 478.19 and J34.89. RESULTS: A total of 34
      patients were evaluated by the Division of Otolaryngology for this chief
      complaint. 38% of neonates were born premature and 32% were admitted to the NICU 
      at birth, with a female-to-male ratio of 1:1.4. Presenting signs and symptoms
      included: stertor (44%), cyanosis (24%), stridor (24%), retractions (21%),
      rhinorrhea (21%), apnea (12%), and epistaxis (8%). 47% of patients received
      ancillary radiographic imaging (CT or MRI). Diagnoses observed include: midnasal 
      stenosis (38%), pyriform aperture stenosis (21%), choanal stenosis (12%),
      dacryocystocele (6%), microrhinia (6%), septal deviation (6%), nasopharyngeal
      reflux (3%), nasopharyngeal teratoma (3%), neonatal rhinitis (3%), and pharyngeal
      wall collapse (3%). 71% of patients were noted to have bilateral nasal
      obstruction. 41% of infants were found to have an associated ear, nose, and
      throat anomaly. 15% of patients required surgical intervention. The mean
      time-to-resolution was 240 days. CONCLUSION: Congenital nasal obstruction has a
      broad differential diagnosis: the timing, onset, and laterality of symptoms can
      provide insights into the source of upper airway compromise. Most infants improve
      through conservative management (i.e. suctioning, humidification) and medical
      therapies (i.e. intranasal drops, nasal sprays).
CI  - Copyright (c) 2017. Published by Elsevier B.V.
FAU - Patel, Vijay A
AU  - Patel VA
AD  - The Pennsylvania State University, College of Medicine, Department of Surgery,
      Division of Otolaryngology - Head and Neck Surgery, Hershey, PA, USA.
FAU - Carr, Michele M
AU  - Carr MM
AD  - The Pennsylvania State University, College of Medicine, Department of Surgery,
      Division of Otolaryngology - Head and Neck Surgery, Hershey, PA, USA. Electronic 
      address: [email protected]
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20170530
PL  - Ireland
TA  - Int J Pediatr Otorhinolaryngol
JT  - International journal of pediatric otorhinolaryngology
JID - 8003603
OTO - NOTNLM
OT  - Airway
OT  - Congenital
OT  - Infant
OT  - Nasal
OT  - Obstruction
OT  - Pediatric
EDAT- 2017/07/10 06:00
MHDA- 2017/07/10 06:00
CRDT- 2017/07/10 06:00
PHST- 2017/03/02 [received]
PHST- 2017/04/27 [revised]
PHST- 2017/05/27 [accepted]
AID - S0165-5876(17)30242-2 [pii]
AID - 10.1016/j.ijporl.2017.05.023 [doi]
PST - ppublish
SO  - Int J Pediatr Otorhinolaryngol. 2017 Aug;99:78-84. doi:
      10.1016/j.ijporl.2017.05.023. Epub 2017 May 30.