Respiratory distress in neonate due to congenital nasal pyriform aperture stenosis

CNPAS is a rare anatomic cause of neonatal nasal obstruction and can lead to respiratory distress, noisy breathing, apnea, as well as poor feeding. 1 - 3 CNPAS results from a bony overgrowth of the medial process of the maxillary sinus, and it could be associated with congenital anomalies such as holoprosencephaly, endocrine defects or a single maxillary central incisor. 2 The management of CNPAS is dependent on the severity of the nasal obstruction.