Upper Airway Obstruction in a Newborn: A Rare Cause of Respiratory Distress

• Tipo: Artigo em Revista Científica Internacional
• Data: 2022

Autores

Santos, NR (Autor) Outra; Mota, R (Autor) Outra; Goncalves, A (Autor) Outra; Spratley, J (Autor) Outra; Henrique Soares (Autor) FMUP

Revista

Título: CUREUS JOURNAL OF MEDICAL SCIENCE

Vol. 14

Editora: Springer Nature

Indexação

ISI Web of Knowledge - 0 Citações

Outras Informações

ID Authenticus: P-00W-8Y4

DOI: 10.7759/cureus.22126

Abstract (EN): Newborns are considered obligate nasal breathers until the eighth week of life. Therefore, upper nasal obstruction in a newborn can present as a potentially life-threatening complication. Congenital nasal pyriform aperture stenosis (CNPAS) is a rare form of upper airway obstruction caused by a narrowing without occlusion in the most anterior opening of the bony nasal airways. According to the severity of this stenosis, early onset of respiratory symptoms can arise in the newborn. In this article, we present the case of a male term newborn with no prior relevant family history and uneventful gestation delivered in a eutocic manner with an adequate transition to the extra-uterine environment. On his first day of life, progressive respiratory distress, inability to breastfeed, and impossibility to make nasogastric probe progress through both sides of the nose were observed, leading the newborn to be admitted to a neonatal intensive care unit. During imagiological assessment with perinasal computerized tomography (CT) scan, an almost total occlusion of the pyriform aperture and a solitary median maxillary central incisor (SMMCI) were identified. Additional evaluation with brain magnetic nuclear resonance imaging (MRI) was unremarkable with no midline defects identified. Endocrine laboratory assessment was also normal. The newborn underwent pyriform aperture permeabilization surgery via a sublabial approach with bilateral nasal stent introduction, enabling total resolution of the initial respiratory symptoms. No incurrences were reported during the post-operatory follow-up period. With the present case report, the authors are trying to raise awareness for CNPAS not only as a rare cause of respiratory distress in the newborn but also as a clinical entity that can be associated with midline defects, which require further additional investigation and intervention.

Idioma: Inglês

Tipo (Avaliação Docente): Científica

Nº de páginas: 8