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Transnasal endoscopic repair of bilateral congenital choanal atresia: controversies

Published online by Cambridge University Press:  25 November 2009

Hesham Mohammad Eladl*
Affiliation:
ORL Department, Mansoura University Hospital, Mansoura University, Egypt
*
Address for correspondence: Dr Hesham Mohammad Eladl, ORL Department, Mansoura University Hospital, Elteraa Rd, abo Hanifa St, Mansoura, Egypt. Postal Code: 35516 E-mail: [email protected]

Abstract

Objective:

To evaluate current concerns about transnasal endoscopic repair of bilateral congenital choanal atresia, regarding technical difficulties, prognostic factors and important controversies.

Patients and methods:

Ten infants with bilateral congenital choanal atresia, aged from 3 to 27 days (mean, 11.2 days) were included. All cases underwent transnasal endoscopic repair and were clinically and endoscopically monitored.

Results:

Of the seven patients treated with stenting, five remained patent and two required minor debridement (with complete patency thereafter). Of the three patients treated without stenting, one remained patent and two required minor debridement (with patency thereafter).

Conclusions:

Transnasal endoscopic repair of bilateral congenital choanal atresia is a safe and successful technique. The use of powered instrumentation in neonatal patients requires experience and a correctly sized drill. Stenting with an appropriate nasal tube for a suitable period is favoured, especially in hospitalised patients.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2009

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References

1 Brown, OE, Smith, T, Armstrong, E, Grundfast, K. The evaluation of choanal atresia by computed tomography. Int J Pediatr Otorhinolaryngol 1986;12:8598CrossRefGoogle ScholarPubMed
2 Van Den Abbeele, T, Francois, M, Narcy, P. Transnasal endoscopic treatment of choanal atresia without prolonged stenting. Arch Otolaryngol Head Neck Surg 2002;128:936–40CrossRefGoogle ScholarPubMed
3 Hengerer, AS, Marshall, S. Choanal atresia: a new embryologic theory and its influence on surgical management. Laryngoscope 1982;92:913–21CrossRefGoogle ScholarPubMed
4 Wiatrak, BJ. Unilateral choanal atresia: initial presentation and endoscopic repair. Int J Pediatr Otorhinolaryngol 1998;15:2735CrossRefGoogle Scholar
5 Pardo Romero, G, Mogollón Cano-Cortés, T, Pando Pinto, JM, Trinidad Ruiz, G, González Palomino, A, Pantoja Hernández, C et al. Endoscopic treatment for choanal atresia [in Spanish]. Acta Otorrinolaringol Esp 2007;58:34–6CrossRefGoogle ScholarPubMed
6 Richardson, MA, Osguthorpe, JD. Surgical management of choanal atresia. Laryngoscope 1988;98:915–18CrossRefGoogle ScholarPubMed
7 Kamel, R. Transnasal endoscopic approach in congenital choanal atresia. Laryngoscope 1994;104:642–6CrossRefGoogle ScholarPubMed
8 Pasquini, E, Sciarretta, V, Saggese, D, Cantaroni, C, Macrì, G, Farneti, G. Endoscopic treatment of congenital choanal atresia. Int J Pediatr Otorhinolaryngol 2003;67:271–6CrossRefGoogle ScholarPubMed
9 Anderhuber, W, Stammberger, H. Endoscopic surgery of uni- and bilateral choanal atresia. Auris Nasus Larynx 1997;24:1319CrossRefGoogle ScholarPubMed
10 Lazar, RH, Younis, RT. Transnasal repair of choanal atresia using telescopes. Arch Otolaryngol Head Neck Surg 1995;121:517–20CrossRefGoogle ScholarPubMed
11 Elloy, MD, Cochrane, LA, Albert, DM. Refractory choanal atresia: what makes a child susceptible? The Great Ormond Street Hospital experience. J Otolaryngol Head Neck Surg 2008;37:813–20Google ScholarPubMed
12 Stankiewicz, JA. The endoscopic repair of choanal atresia. Otolaryngol Head Neck Surg 1990;103:931–7CrossRefGoogle ScholarPubMed
13 Andrieu, J, Guitrancourt, P, Stipon, M. Surgery of choanal atresia [in French]. In: Surgical Techniques-Head and neck. EMC, Editions Techniques, Paris 1994;[46–230]:110Google Scholar
14 Friedman, NR, Mitchell, RB, Bailey, CM, Albert, DM, Leighton, SE. Management and outcome of choanal atresia correction. Int J Pediatr Otorhinolaryngol 2000;52:4551CrossRefGoogle ScholarPubMed
15 Samadi, DS, Shah, UK, Handler, SD. Choanal atresia: a twenty-year review of medical comorbidities and surgical outcomes. Laryngoscope 2003;113:254–8CrossRefGoogle ScholarPubMed
16 Cedin, AC, Peixoto Rocha, JF Jr, Deppermann, MB, Moraes Manzano, PA, Murao, M, Shimuta, AS. Transnasal endoscopic surgery of choanal atresia without the use of stents. Laryngoscope 2002;112:750–2CrossRefGoogle ScholarPubMed
17 Holland, BW, McGuirt, WF Jr. Surgical management of choanal atresia: improved outcome using mitomycin. Arch Otolaryngol Head Neck Surg 2001;127:1375–80CrossRefGoogle ScholarPubMed
18 Khafagy, YW. Endoscopic repair of bilateral congenital choanal atresia. Laryngoscope 2002;112:316–19CrossRefGoogle ScholarPubMed
19 McLeod, IK, Brooks, DB, Mair, EA. Revision choanal atresia repair. Int J Pediatr Otorhinolaryngol 2003;67:517–24CrossRefGoogle ScholarPubMed
20 Schoem, SR. Transnasal endoscopic repair of choanal atresia: why stent? Otolaryngol Head Neck Surg 2004;131:362–6CrossRefGoogle ScholarPubMed
21 Mumbuç, S, Karataş, E, Durucu, C, Ozer, E, Kanlıkama, M. Transnasal endoscopic repair of choanal atresia [in Turkish]. Kulak Burun Bogaz Ihtis Derg 2007;17:85–9Google ScholarPubMed
22 Yaniv, E, Hadar, T, Shvero, J, Stern, Y, Raveh, E. Endoscopic transnasal repair of choanal atresia. Int J Pediatr Otorhinolaryngol 2007;71:457–62CrossRefGoogle ScholarPubMed
23 Kubba, H, Bennett, A, Bailey, CM. An update on choanal atresia surgery at Great Ormond Street Hospital for Children: preliminary results with mitomycin C and the KTP laser. Int J Pediatr Otorhinolaryngol 2004;68:939–45CrossRefGoogle Scholar
24 Saetti, R, Santoro, R, Silvestrini, M. Choanal atresia: endoscopic trans-nasal approach. International Congress Series 2003;1254:443–5CrossRefGoogle Scholar
25 Westendorff, C, Dammann, F, Reinert, S, Hoffmann, J. Computer-aided surgical treatment of bilateral choanal atresia. J Craniofac Surg 2007;18:654–60CrossRefGoogle ScholarPubMed