Choanal Atresia – A Permanent Challenge in Rhinology Pathology

Abstract

Abstract. Choanal atresia is the most frequent nasal congenital malformation, which, depending on the unilateral or bilateral location, has a different symptomatology. The diagnosis is confirmed through the patient's medical history, nasal endoscopy and imagistic examination (computed tomography). The treatment is surgical and aims the (fibrous and bone) tissue disintegration which blocks the choana, and is performed through endoscopic surgical techniques. The blocked area is maintained functional by mounting a stent at the choanal tunnel level. The authors aim to describe their own experience regarding both the diagnoses as well as the treatment of this pathology, the results being compared to those from the quoted literature. The surgical technique differs depending on the type of choanal atresia: bone or membranous. The duration to maintain a fix position of the stent and the material used for the stent represent the variables which provide the success of the endoscopic surgical intervention of the choanal atresia. Subsequently, the patient is followed up at 2, 6, 12 months in the first year and then annually until 18 years of age. Choanal atresia is solved through endoscopic surgical techniques by mounting a silicone stent which shall be maintained in position for a minimum period of 3 months. The endoscopic approach of the unilateral choanal imperforation is the method of choice with minimum complications, increased success rate and fast recovery.

Complications of Endoscopic Surgery of Congenital Choanal Atresia: How to Avoid It?

“…The resection of atretic plate usually started at junction between vomer and hard palate at the inferomedial direction of atretic plate which represent the safest portion of blocking membrane to avoid hemorrhagic complications (Sphenopalatine & Vidian artery injury). The use of soft tissue shaver and small drill is less traumatic to nasal mucosa which decrease risk of bleeding (22) .…”