Pyriform Aperture Stenosis Repair

The pyriform aperture is part of the bony opening of the nose. In rare cases, babies may be born with a narrowing of this opening (pyriform aperture stenosis) A pyriform aperture stenosis repair is an operation to widen the pyriform aperture opening inside the nose.

Pyriform aperture stenosis repair is performed in one of two ways:

• Endoscopy: The surgeon uses tiny instruments inside a lighted tube called an endoscope. An inflatable balloon may be used to widen the airway.
• Open surgery: The surgeon reaches the narrowed bone through a surgical opening made in the skin of the inside of the upper lip.

Babies having pyriform aperture stenosis repair are likely to recover quickly and the risk of problems is low. Here are some other advantages:

• Breathing and feeding improve after the procedure.
• There is no scarring visible on your child’s face.

Problems after pyriform aperture stenosis repair are rare, but can include:

• Restenosis (the aperture becoming narrow again)
• Need for additional procedures

Consulting a board-certified otolaryngologist (ear, nose and throat specialist) who specializes in children’s care minimizes risks. 

Pyriform aperture stenosis repair takes place in a hospital operating room. It typically takes 1 to 2 hours and involves the following steps:

1. The doctor gives general anesthesia, so your baby sleeps through the operation.
2. The doctor inserts a tube called an endoscope into your child’s nose or makes a small surgical opening in the inside of the upper lip.
3. Using a tiny drill, the doctor carefully removes some of the bony tissue inside the nose to widen the passageway. 

Recovery from a pyriform aperture stenosis repair:

1. The team may place hollow tubes called stents into your child’s nose to keep the airway open while healing takes place.
2. Your child stays in the hospital for 1 to 2 weeks. 

The doctor will follow up and examine the inside of your baby’s nose with an endoscope to see how healing is coming along. 

Most children’s pyriform aperture stenosis improves as they grow, but early diagnosis and evaluation are important to help your baby stay comfortable and breathe easily.