Imaging studies in the diagnostic workup of neonatal nasal obstruction

Twelve neonates presenting with nasal obstruction after birth were evaluate d by imaging studies for diagnostic reasons. Four groups were recognized: G roup I: choanal atresia (n = 5) and choanal stenosis (n = 1); Group II: con genital nasal pyriform aperture stenosis (CNPAS) (n = 3) and holoprosenceph aly (n = 1); Group III: nasolacrimal duct mucocele (n = 1); Group IV: nasal hypoplasia (n = 1). Associated anomalies were found in eight patients. Fou r patients with choanal atresia showed manifestations of the CHARGE (colobo ma, congenital heart defect, atretic choanae. retarded physical and neuromo tor development associated with central nervous system anomalies, genital h ypoplasia, and ear anomaly and/or deafness) association. In the fifth patie nt with choanal atresia, the diagnosis of amnion disruption sequence was ma de. One patient with CNPAS had a solitary maxillary central incisor (SMCI), a mild form of holoprosencephaly. Besides proboscis and synophthalmos, SMC I was also present in the holoprosencephaly case. The patient with severe n asal hypoplasia had warfarin embryopathy. This review emphasizes the need f or performing imaging studies in the diagnostic workup of neonates born wit h nasal obstruction.