Comprehensive management of congenital choanal atresia

Brihaye, Pierre; Delpierre, Isabelle; Villé, A. De; Johansson, Anne Britt; Biarent, Dominique; Mansbach, Anne-Laure

doi:10.1016/j.ijporl.2017.04.022

Cited by 25 publications

(28 citation statements)

References 68 publications

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“…Although numerous studies have reported the success of using stents post-surgery in the repair of CA, several studies have also reported favorable outcomes without the use of stents. In a retrospective study, Brihaye et al [20] comprehensively analyzed the outcomes of surgery for CA without the use of a stent in 36 children, from 1999 to 2015, with 50% unilateral and 50% bilateral cases. Fibrin glue was used to attach the mucosal flaps, and the patients were followed up for six years on average.…”

Section: Reviewmentioning

confidence: 99%

Choanal Atresia Repair in Pediatric Patients: Is the Use of Stents Recommended?

Albdah¹,

Alanbari

Alwadi

2019

Cureus

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Choanal atresia, the obliteration or narrowing of nasal choana, is widely studied across the pediatric and adult population. While unilateral choanal atresia can remain unidentified for several years, bilateral choanal atresia requires immediate intervention, as children are primarily nasal breathers until the initial four months of age. Several surgical methods are reported for repairing choanal atresia in children, and the choice of postoperative management with or without stents is still controversial. In this review, we analyzed several recent studies in which surgery for choanal atresia repair was followed by stent-assisted and/or stentless management. The results of this study are likely to pave the way for a further understanding of the choice of method to increase patency and reduce possible complications.

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Section: Reviewmentioning

confidence: 99%

Choanal Atresia Repair in Pediatric Patients: Is the Use of Stents Recommended?

Albdah¹,

Alanbari

Alwadi

2019

Cureus

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“…[15][16][17] However, with the advent of modern endoscope technology, transnasal endoscopic repair has emerged as the preferred technique as it allows for a singlestage procedure with preservation of normal facial structures and an early return to spontaneous breathing and feeding without the risks of palatal fistula, dentoalveolar growth issues, cross-bite deformity, and prolonged postoperative recovery. 2,[18][19][20] Likewise, stenting after choanal atresia repair was once standard to decrease the risk of restenosis after transnasal puncture. A survey of members of the American Society of Pediatric Otolaryngology in 2000 reported that only 3 out of 95 members did not routinely use stents.…”

Section: Introductionmentioning

confidence: 99%

Use of Steroid-Eluting Stents after Endoscopic Repair of Choanal Atresia: A Case Series with Review

Wilcox

Smith

Alarcón

et al. 2020

Ann Otol Rhinol Laryngol

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Objective(s): To describe a single institution’s experience with the use of steroid-eluting stents after endoscopic transnasal repair of choanal atresia. Methods: A case series with review of children who underwent choanal atresia repair at a tertiary children’s hospital from June 2017 to January 2018 was performed. Those who had a mometasone drug-eluting stent (Propel® Mini, Intersect ENT Inc., Palo Alto, CA) placed after primary or secondary choanal atresia repair at our institution were included. The primary outcome measure was need for revision surgery due to stenosis. Postoperative regimens, duration of stenting, and need for return to the operating room (OR) were also assessed. Results: Five patients with a median age of 22 months at the time of repair met inclusion criteria. Two (40%) had bilateral atresia and 3 (60%) had confirmed CHARGE syndrome. A total of 6 mometasone drug-eluting stents were used in the 5 cases. Three patients were reassessed at least once in the OR; however, the majority (57.1%) of postoperative evaluations were able to be performed in the office or bedside setting. The first and last evaluations occurred a mean of 14 and 124 days after surgery, respectively. There were no instances of restenosis, repeat surgical interventions, or stent-related complications noted. Conclusion: Placement of a mometasone drug-eluting stent is a promising method to improve postoperative results and management of choanal atresia repair by limiting the need for repeat anesthetics and OR procedures, as well as the complications of traditional stents.

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“…Показаниями для эндоскопического хирургического лечения являются различные патологические изменения внутриносовых структур и околоносовых пазух у детей: синуситы, опухоли, травматические и врожденные пороки развития полости носа и основания черепа [7]. Среди детей с пороками развития наиболее часто оперативные вмешательства производят по поводу врожденной атрезии хоан [8,18,19,20,21]. В последние годы все чаще применяется трансназальный микрохирургический метод хоанотомии с применением современной эндоскопической техники, как наиболее легко выполнимый, щадящий, безопасный и отличающийся высоким уровнем успеха [5,22,23,24,27].…”

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Age-related description of the posterior structures of the nasal cavity in children

Гайворонский

Маркеева

Алешкина

et al. 2020

Žurnal anatomii i gistopatologii

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The aim of the study was to describe morphometric characteristics of the posterior parts of the nasal cavity in different periods of childhood and to specify the age-related norm for improving surgical treatment options of choanal atresia and providing an optimal access to the anterior part of the skull base. Material and methods. The study included 87 children aged 1-21 who were exposed to craniometry of the nasal cavity structures. Results. The age-related variability of the linear dimensions and shape of the choanae, their relationship with the dimensions of the pyriform aperture and the height of the nasal cavity in the posterior part were defined in the study. The increase in the height of the choanae and the height of the nasal cavity at the back starts from 2– 3 years of age, and the width – from 8–12 years of age. The height and width of the pyriform aperture are equal to the age of 8–12; these parameters increase in older children's groups with a predominance of the height over the width. The height of the nasal cavity at the back increases in all age periods. The growth of the studied structures of the nasal cavity is completed by adolescence. In infancy, the height of the choanae is less than the height of the nasal cavity at the back by 45%, and less than the height of the pyriform aperture by 20%; in adolescence, these ratios are 42% and 23%, respectively. In infancy the choanal width is less than the width of the pyriform aperture by 49%, and in adolescence – by 40%. In infancy and early childhood, the choanae are typically small in height and width. Their shape is round in 25% of cases, however, ovoid shape is also found. The height and width of the pyriform-shaped aperture at these age periods are similar and do not exceed 17–18 mm; the height of the nasal cavity at the back is 25–27 mm. Conclusion. The authors have described age-related morphometric features of the posterior structures of the nasal cavity. These features should be taken into account by otorhinolaryngologists and neurosurgeons when planning endoscopic intranasal surgical access in children. The younger the child is, the more difficult it is to perform a surgery due to the significant restriction of the access resulted from the small size of the piriform opening and the nasal cavity, and the obstinacy of the nasal septum. When performing choanotomy for atresia, it is necessary to form the choana comparing it in shape and size with the age-related norm

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Comprehensive management of congenital choanal atresia

Cited by 25 publications

References 68 publications

Choanal Atresia Repair in Pediatric Patients: Is the Use of Stents Recommended?

Choanal Atresia Repair in Pediatric Patients: Is the Use of Stents Recommended?

Use of Steroid-Eluting Stents after Endoscopic Repair of Choanal Atresia: A Case Series with Review

Age-related description of the posterior structures of the nasal cavity in children

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