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Acta Otorrinolaringológica Española Newborn nasal obstruction: Rare anatomical causes to consider
Journal Information
Vol. 76. Issue 6.
(November - December 2025)
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Vol. 76. Issue 6.
(November - December 2025)
Brief communication
Newborn nasal obstruction: Rare anatomical causes to consider
Obstrucción nasal neonatal: Causas anatómicas raras a considerar
Montserrat Asensi-Diaza,
Corresponding author
, Alejandro Lowy Benoliela, Juan Antonio Pasamontes Pingarrona, Ismael Nieva Pascualb, Pilar Cifuentes Canoreab, Monica Hernando Cuñadoa
a Otorhinolaryngology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
b Ophthalmology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
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Abstract

Neonatal nasal obstruction, though rare, can be life-threatening due to the obligate nasal breathing pattern in newborns. Even partial obstruction may compromise ventilation and feeding.

This study aims to describe rare anatomical causes of neonatal nasal obstruction, highlighting their clinical presentation, diagnostic evaluation, and management.

A retrospective review was conducted of four neonates with respiratory distress who were diagnosed with congenital nasal malformations through endoscopic examination and craniofacial imaging. The identified cases included bilateral choanal atresia in a patient with CHARGE syndrome, congenital nasal pyriform aperture stenosis (CNPAS) with a solitary median mega-incisor, isolated CNPAS with midnasal hypoplasia, and bilateral congenital dacryocystoceles. Symptoms ranged from noisy breathing to feeding intolerance. Management included both medical and surgical interventions depending on the severity of the obstruction.

Although infrequent, anatomical nasal anomalies should be promptly considered in neonates presenting with respiratory distress, as early diagnosis and appropriate treatment are essential to avoid complications and ensure favourable outcomes.

Keywords:
Newborn nasal obstruction
CNPAS
midnasal hypoplasia
Congenital dacryocystoceles
Choanal atresia
Resumen

La obstrucción nasal neonatal, aunque poco frecuente, puede poner en riesgo la vida debido a la respiración nasal obligada en los recién nacidos. Incluso una obstrucción parcial puede comprometer la ventilación y la alimentación.

Este estudio tiene como objetivo describir causas anatómicas raras de obstrucción nasal neonatal, destacando su presentación clínica, evaluación diagnóstica y manejo.

Se realizó una revisión retrospectiva de cuatro neonatos con distrés respiratorio que fueron diagnosticados con malformaciones nasales congénitas mediante endoscopia nasal e imagen craneofacial. Los casos identificados incluyeron una atresia coanal bilateral en un paciente con síndrome de CHARGE, una estenosis congénita de la apertura piriforme nasal (ECAP) con un mega-incisivo medio solitario, una ECAP aislada con hipoplasia medionasal y dacriocistoceles congénitos bilaterales. Los síntomas variaron desde respiración ruidosa hasta intolerancia a la alimentación. El tratamiento incluyó intervenciones médicas y quirúrgicas según la gravedad de la obstrucción.

Aunque infrecuentes, las anomalías anatómicas nasales deben considerarse de forma temprana en neonatos con distrés respiratorio, ya que el diagnóstico precoz y el tratamiento adecuado son esenciales para evitar complicaciones y asegurar un buen pronóstico.

Palabras clave:
Obstrucción nasal neonatal
Hipoplasia nasal media congénita
Dacriocistoceles congénitos
Atresia coanal

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