Midnasal stenosis in adults with normative values

J Laryngol Otol. 2022 Jul;136(7):639-644. doi: 10.1017/S0022215121004606. Epub 2022 Jan 7.

Abstract

Background: Congenital midnasal stenosis has previously been described as a cause of nasal obstruction in infants, and conservative and interventional treatments have been suggested. However, midnasal stenosis in adults has not been reported and related normative measurements have not been studied.

Methods: Three adult patients presented with nasal obstruction and, based on examination and radiological findings, were diagnosed with midnasal stenosis. Anatomical measurements were studied in axial and coronal computed tomography scans, and compared with findings for 161 healthy individuals.

Results: Anatomical measurements showed that the endonasal cavity was larger in males than females. The midnasal region was found to be constricted in patients compared to healthy controls.

Conclusion: This is the first study to report on midnasal stenosis in adults and to define normative anatomical measurements in adults. In patients presenting with nasal obstruction, midnasal stenosis should be suspected during endoscopic visualisation of medially located middle turbinates and uncinate processes in nasal cavities. A definitive diagnosis of midnasal stenosis can be made by examining paranasal sinus computed tomography scans. Endoscopic middle turbinectomy, complete uncinectomy, mega maxillary antrostomy and partial anterior ethmoidectomy have been suggested to relieve midnasal stenosis.

Keywords: Maxillary Sinus; Nasal Obstruction; Nose; Paranasal Sinuses; Turbinates.

MeSH terms

  • Adult
  • Constriction, Pathologic / diagnostic imaging
  • Constriction, Pathologic / surgery
  • Female
  • Humans
  • Infant
  • Male
  • Nasal Cavity / abnormalities
  • Nasal Cavity / diagnostic imaging
  • Nasal Cavity / surgery
  • Nasal Obstruction* / diagnostic imaging
  • Nasal Obstruction* / etiology
  • Nasal Obstruction* / surgery
  • Nose Diseases* / complications
  • Reference Values
  • Turbinates