Hypoplasia of the Maxilla: Differential Diagnosis of Nasal Obstruction in Infants

Introduction: The maxillary hypoplasia (MH) is a rare cause of respiratory distress in newborns (NB), which may be associated with genetic disorders such as holoprosencephaly and Apert syndrome. This pathology is part of the differential diagnosis of congenital nasal obstruction in neonates, along with choanal atresia and stenosis of the piriform aperture and nasolacrimal duct cyst.

Objective: This study aims to describe a series of cases of NB with this disease.

Method: We describe the cases of NB with MH who were evaluated at our institution, as well as diagnostic methods and specific action in each case.

Results: We evaluated seven NB with this disease and note that the first signs presented by these children were respiratory effort and difficult to move the suction catheter through the nostrils, and choanal atresia diagnosed the first hypothesis formulated in all cases by pediatricians. The first test performed on all NB was nasal endoscopy at the bedside, with subsequent complementation with the tomography of bones face (TCF). Surgical treatment with osteogenic distractor placement of the maxilla was performed in three of our patients and tracheostomy in two patients. TCF width measurements of the piriform aperture, the inner nose, were compared with age matched and sex with p < 0.005 controls.

Conclusion: The MH must be addressed by a multidisciplinary team, as this is a change in several genetic syndromes and craniofacial malformations. Although rare, it should be considered in NB with nasal obstruction and narrowing of nasal passages nasal endoscopy.