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Imaging Studies in the Diagnostic Workup of Neonatal Nasal Obstruction

Vanzieleghem, Bart D.; Lemmerling, Marc M.; Vermeersch, Hubert F.; Govaert, Paul; Dhooge, Ingeborg; Meire, Françoise; Mortier, Geert R.; Leroy, Jules; Kunnen, Marc F.

Journal of Computer Assisted Tomography: July/August 2001 - Volume 25 - Issue 4 - pp 540-549
NEURORADIOLOGY: Pictorial Essay

Twelve neonates presenting with nasal obstruction after birth were evaluated by imaging studies for diagnostic reasons. Four groups were recognized: Group I: choanal atresia (n = 5) and choanal stenosis (n = 1); Group II: congenital nasal pyriform aperture stenosis (CNPAS) (n = 3) and holoprosencephaly (n = 1); Group III: nasolacrimal duct mucocele (n = 1); Group IV: nasal hypoplasia (n = 1). Associated anomalies were found in eight patients. Four patients with choanal atresia showed manifestations of the CHARGE (c oloboma, congenital h eart defect, a tretic choanae, r etarded physical and neuromotor development associated with central nervous system anomalies, g enital hypoplasia, and e ar anomaly and/or deafness) association. In the fifth patient with choanal atresia, the diagnosis of amnion disruption sequence was made. One patient with CNPAS had a solitary maxillary central incisor (SMCI), a mild form of holoprosencephaly. Besides proboscis and synophthalmos, SMCI was also present in the holoprosencephaly case. The patient with severe nasal hypoplasia had warfarin embryopathy. This review emphasizes the need for performing imaging studies in the diagnostic workup of neonates born with nasal obstruction.

From the Departments of Radiology (B. D. Vanzieleghem, M. M. Lemmerling, and M. F. Kunnen), Head and Neck Surgery (H. F. Vermeersch), Neonatology (P. Govaert and J. Leroy), Otorhinolaryngology (I. Dhooge), Ophthalmology (F. Meire), and Medical Genetics (G. R. Mortier), Ghent University Hospital, Ghent, Belgium.

Address correspondence and reprint requests to Dr. B. D. Vanzieleghem at Department of Radiology, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent, Belgium. E-mail: bart.vanzieleghem@rug.ac.be

© 2001 Lippincott Williams & Wilkins, Inc.