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Clinical Problem Solving: Radiology
March 21, 2011

Radiology Quiz Case 1: Diagnosis

Arch Otolaryngol Head Neck Surg. 2011;137(3):304. doi:10.1001/archoto.2011.26-b

Congenital nasal pyriform aperture stenosis, which was first described in 1989, is a rare cause of upper airway obstruction that occurs in newborns.1The pyriform aperture is bounded superiorly by the nasal bones, laterally by the nasal process of the maxilla, and inferiorly by the horizontal process of the maxilla.2The anatomical obstruction created by CNPS is due to excessive growth of the medial nasal process of the maxilla, which leads to narrowing of the bony nasal cavity.3Embryologically, nasal development occurs during the fifth to eighth week of gestation. While the medial nasal prominences are fusing to form the primary palate, the developing maxilla meets the lateral prominence to form the lateral nasal wall and pyriform aperture. It is believed that overgrowth of maxillary ossification results in narrowing of the pyriform aperture.1

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