Congenital pyriform aperture stenosis: Ten years experience.

INTRODUCTION: Congenital nasal pyriform aperture stenosis (CNPAS) is an uncommon malformation and a rare cause of respiratory distress in neonates that may require early surgical intervention. The aim of this study is to report our experience in patients operated for CNPAS and present characteristics of this population. MATERIAL AND METHODS: A retrospective, analytical cohort study was conducted of patients who underwent surgical treatment for CNPAS in the Hospital de Pediatría Garrahan from May 2008 to May 2018. RESULTS: Nineteen patients underwent surgical treatment; 47.36% had some associated genetic syndrome. The surgical approach was sublabial. Follow-up was more than 45 days in 14 patients, 9 did not require additional treatment, and the remaining 5 required further surgical and/or medical treatment. Short-term post-surgical outcome was good in 85.7%. CONCLUSIONS: Better post-surgical results were obtained in patients in whom endonasal stenting was not used and who did not present associated craniofacial malformations.

Estenosis congénita de apertura piriforme: diez años de experiencia / Congenital pyriform aperture stenosis: ten years experience

Introducción: La estenosis congénita de la apertura piriforme (ECAP) es una malformación infrecuente y una causa rara de distress respiratorio en neonatos que puede requerir de intervención quirúrgica temprana. El objetivo del estudio es reportar nuestra experiencia en pacientes operados por ECAP y las características de la población.Material y métodosPacientes operados de ECAP desde mayo del 2008 hasta mayo del 2018 en el Hospital de Pediatría Garrahan. Estudio de cohorte analítico retrospectivo.ResultadosSe intervinieron quirúrgicamente 19 pacientes. El 47,36% presentaba algún síndrome genético asociado. El abordaje quirúrgico fue por vía sublabial. Se logró el seguimiento por más de 45 días en 14 pacientes, 9 no requirieron tratamiento adicional, y los 5 restantes requirieron otro tratamiento quirúrgico y/o médico. El éxito global posquirúrgico en primera instancia fue del 85,7%.ConclusionesSe obtuvieron mejores resultados posquirúrgicos en los pacientes en que no se utilizaron tutores endonasales y que no presentaban malformaciones craneofaciales asociadas. (AU)

Introduction: Congenital nasal pyriform aperture stenosis (CNPAS) is an uncommon malformation and a rare cause of respiratory distress in neonates that may require early surgical intervention.The aim of this study is to report our experience in patients operated for CNPAS and present characteristics of this population.Material and methodsA retrospective, analytical cohort study was conducted of patients who underwent surgical treatment for CNPAS in the Hospital de Pediatría Garrahan from May 2008 to May 2018.ResultsNineteen patients underwent surgical treatment; 47.36% had some associated genetic syndrome. The surgical approach was sublabial. Follow-up was more than 45 days in 14 patients, 9 did not require additional treatment, and the remaining 5 required further surgical and/or medical treatment. Short-term post-surgical outcome was good in 85.7%.ConclusionsBetter post-surgical results were obtained in patients in whom endonasal stenting was not used and who did not present associated craniofacial malformations. (AU)

Resorbable airway splint, stents, and 3D reconstruction and printing of the airway in tracheobronchomalacia.

Tracheobronchomalacia (TBM) is the most common tracheobronchial obstruction. Most cases are mild to moderate; therefore, they do not need surgical treatment. Severe tracheomalacia, however, represents a diagnostic and therapeutic challenge since they are very heterogeneous. In the armamentarium of resources for the treatment of dynamic airway collapse, splints and stents are two underused strategies and yet, they may represent the best alternative in selected cases. Lately, computed tomography 3D reconstruction of the airway has been used for the design of virtual models that can be 3D-printed for the creation of novel devices to address training, simulation, and biotechnological implants for refractory and severe airway malformations. This manuscript examines the role of resorbable stents, splints, and the 3D reconstruction and printing of the pediatric airway in tracheobronchomalacia.