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Clinical Problem Solving: Radiology
March 21, 2011

Radiology Quiz Case 1

Author Affiliations
 

C. DOUGLASPHILLIPSMD

Arch Otolaryngol Head Neck Surg. 2011;137(3):302. doi:10.1001/archoto.2011.26-a

A 4-week-old girl presented with obstructed nasal breathing. She had been born at 37 weeks' gestation, and her Apgar scores were 9 and 9 at 1 and 5 minutes. After her birth, she was transferred to the neonatal intensive care unit (NICU), where she was intubated because of tachypnea and increased difficulty in breathing. Feedings were initiated by nasogastric route, and the neonatologist noted that a nasogastric tube could be passed through both sides of the nasal cavity. The patient was extubated after 7 days. At the time of discharge, the neonatologist noted ongoing “nasal stuffiness.” At home, the patient continued to experience inspiratory difficulty during periods of agitation, which her mother alleviated with upright positioning. Although she had appropriate weight gain, her mother was concerned by her episodes of noisy breathing.

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