Comparison of Surgical Techniques for the Treatment of Congenital Nasal Pyriform Aperture Stenosis: A Systematic Review.

IF 1.3 4区医学 Q3 OTORHINOLARYNGOLOGY

Annals of Otology Rhinology and Laryngology Pub Date : 2024-07-01 Epub Date: 2024-03-28 DOI:10.1177/00034894241242179

Mattie Rosi-Schumacher, Lauren A DiNardo, Alyssa D Reese, Soumya Gupta, Ryan E Nagy, Saptarshi Chakraborty, Michele M Carr

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引用次数: 0

Abstract

Introduction: Congenital nasal pyriform aperture stenosis (CNPAS) is a rare condition that results in neonatal respiratory difficulty. The purpose of this systematic review was to compare surgical outcomes of drilling versus dilation techniques in the treatment of CNPAS.

Methods: Pubmed, Embase, and Cochrane Clinical Trials databases were searched for terms "congenital nasal pyriform aperture stenosis" or "pyriform aperture stenosis" from 2010 to 2021. Twenty-five studies were included that evaluated pediatric patients treated surgically for CNPAS with available outcomes data including complications, revisions, and length of stay.

Results: A total of 51 patients with CNPAS were pooled from included studies. The median age was 29 days, 56.9% were female, and 54.9% were born full-term. The median pyriform aperture width before surgery was 5.00 mm (IQR = 4.10, 6.45). Forty (78.4%) patients underwent sublabial drilling, while 6 had a dilation procedure performed with hegar cervical dilators, 2 had a balloon dilation, and 3 were dilated with either an acrylic device, endotracheal tube, or bougie. There were no post-operative complications for 76.5% of patients, while a second surgery was required in 9 (17.6%) patients. The median length of stay was 11 days (IQR = 4, 26). No statistically significant difference was observed between sublabial drilling and surgical dilation techniques with respect to complications, need for revision surgery, or length of stay.

Conclusion: Current literature is insufficient to determine if drilling or dilation is more effective in the treatment of CNPAS.

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治疗先天性鼻梨状孔狭窄的手术技术比较：系统性综述。

导言先天性鼻梨状孔狭窄（CNPAS）是一种导致新生儿呼吸困难的罕见疾病。本系统综述旨在比较钻孔与扩张技术治疗 CNPAS 的手术效果：方法：以 "先天性鼻梨状孔狭窄 "或 "梨状孔狭窄 "为关键词，检索了 2010 年至 2021 年期间的 Pubmed、Embase 和 Cochrane 临床试验数据库。共纳入25项研究，这些研究对接受CNPAS手术治疗的儿科患者进行了评估，并提供了包括并发症、翻修和住院时间在内的结果数据：从纳入的研究中汇总了51名CNPAS患者。中位年龄为29天，56.9%为女性，54.9%为足月儿。术前梨状孔宽度的中位数为 5.00 毫米（IQR = 4.10，6.45）。40名患者（78.4%）接受了阴道下钻孔术，6名患者使用hegar宫颈扩张器进行扩张，2名患者使用球囊扩张，3名患者使用丙烯酸装置、气管插管或吸管进行扩张。76.5%的患者术后未出现并发症，而有9名患者（17.6%）需要进行第二次手术。住院时间中位数为 11 天（IQR = 4，26）。在并发症、翻修手术需求或住院时间方面，阴道下钻孔和手术扩张技术之间没有统计学意义上的差异：目前的文献不足以确定钻孔还是扩张在治疗 CNPAS 方面更为有效。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Otology Rhinology and Laryngology 医学-耳鼻喉科学

CiteScore

3.10

自引率

7.10%

发文量

171

审稿时长

4-8 weeks

期刊介绍： The Annals of Otology, Rhinology & Laryngology publishes original manuscripts of clinical and research importance in otolaryngology–head and neck medicine and surgery, otology, neurotology, bronchoesophagology, laryngology, rhinology, head and neck oncology and surgery, plastic and reconstructive surgery, pediatric otolaryngology, audiology, and speech pathology. In-depth studies (supplements), papers of historical interest, and reviews of computer software and applications in otolaryngology are also published, as well as imaging, pathology, and clinicopathology studies, book reviews, and letters to the editor. AOR is the official journal of the American Broncho-Esophagological Association.