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Case 40: Congenital Pyriform Aperture Stenosis¹

¹ From the Departments of Radiology (N.R., T.B.) and Ear Nose Throat (M.B.), Children’s Medical Center, 1935 Motor St, Dallas, TX 75235. Received April 5, 2000; revision requested May 1; revision received July 12; accepted August 2. Address correspondence to N.R. (e-mail: nrolli@childmed.dallas.tx.us).

View larger version (128K): [in a new window]   Figure 1a. (a) Transverse CT image obtained through the nasal cavity. There is overgrowth of the nasal processes of the maxilla (long arrows) resulting in obstruction of the pyriform apertures (short arrows). (b) Transverse CT image obtained through the maxillary alveolar ridge. Curved arrow indicates a single mega-incisor.

View larger version (136K): [in a new window]   Figure 1b. (a) Transverse CT image obtained through the nasal cavity. There is overgrowth of the nasal processes of the maxilla (long arrows) resulting in obstruction of the pyriform apertures (short arrows). (b) Transverse CT image obtained through the maxillary alveolar ridge. Curved arrow indicates a single mega-incisor.

View larger version (118K): [in a new window]   Figure 2. Transverse CT image obtained through the nasal cavity in a normal neonate. Long arrows indicate normal nasal processes. Note the caliber of the pyriform apertures (short arrows).

View larger version (134K): [in a new window]   Figure 3. Transverse CT image obtained through the nasal cavity in a neonate with right posterior choanal narrowing. The lateral wall (arrow) of the right nasal cavity is bowed medially.

View larger version (118K): [in a new window]   Figure 4. Sagittal T1-weighted spin-echo MR (repetition time msec/echo time msec, 500/25; number of signals acquired, two) image in a neonate with an intranasal encephalocele. Arrows indicate an encephalocele in the posterior nasopharynx that has herniated through a congenital defect in the basisphenoid. The corpus callosum is absent.