Operative Management of Choanal Atresia

Newman, J. Robert; Harmon, Paula; Shirley, W. Peyton; Hill, Jonathan; Woolley, Audie L.; Wiatrak, Brian J.

doi:10.1001/jamaoto.2013.1111

Cited by 66 publications

(55 citation statements)

References 18 publications

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“…22 Tessier et al 10 reported the mean operation age of 80 patients with bilateral and unilateral CCA was between 3 days and 17 years, and in another study (31 patients), it was between 3 days and 15 years. 16 The mean follow-up time reported in studies is between 6 and 46 months. 6,10,14,18,23Y25 In our study, the mean age was 37 days in group I and 12.3 years in group II.…”

Section: Discussionmentioning

confidence: 99%

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Patients With Congenital Choanal Atresia Treated by Transnasal Endoscopic Surgery

Kınış

Özbay

Akdağ

et al. 2014

Journal of Craniofacial Surgery

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Congenital choanal atresia (CCA) is defined as a congenital failure in the development of communication between the nasal cavity and nasopharynx in newborns. It is the most common congenital anomaly of nose. Most of the patients presented with unilateral CCA. Neonates with bilateral CCA have severe respiratory distress after birth. Airway control with orotracheal intubation should be done immediately to save the life of neonate with bilateral CCA. After airway control, surgery should be performed as soon as possible. The aim of surgery is to create a patent nasal passage and to prevent restenosis with minimal morbidity. Transnasal endoscopic surgery of CCA has become the most popular treatment method. The retrospective review of 33 patients with CCA was presented in this study. The patients who were diagnosed at the neonate period and operated on in 6 months after birth were grouped as I (neonate). The patients who were diagnosed 6 months after birth were grouped as II (child-young adult). All patients were treated by transnasal endoscopic surgery. Stent were put in all patients to prevent restenosis. Although the restenosis rate was higher in group I (53.8%) than in group II (23.1%), it did not cause a statistically significant difference. Overall success rate of our surgical approach was 61.5%. Despite the surgical developments and many treatment modalities, restenosis is still the most challenging problem in CCA.

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Section: Discussionmentioning

confidence: 99%

“…5 Similar results were also reported in many studies. 8,10,11,14,16,17,21,23 The patients with stenting should receive antibiotic treatment to reduce the incidence of infection. 10,16,17 We use stent in all our patients.…”

Section: Discussionmentioning

confidence: 99%

Patients With Congenital Choanal Atresia Treated by Transnasal Endoscopic Surgery

Kınış

Özbay

Akdağ

et al. 2014

Journal of Craniofacial Surgery

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“…Another study by Newman et al, 6 deals with 33 patients (31 endoscopic, 2 transnasal). Forty-three sides were operates endoscopically, 9 required revision surgeries.…”

Section: Discussionmentioning

confidence: 99%

Pediatric Choanal Atresia: Our Experience

Gupta¹,

Grover²,

Bhargava³

et al. 2014

An International Journal Clinical Rhinology

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Objective: To discuss our experience with choanal atresia and factors affecting the results. Materials and methods:A multicentric prospective study of patients diagnosed with choanal atresia from April 2008 to January 2014 at SMS Medical College, Jaipur and SP Medical College, Bikaner was conducted. All patients were evaluated by CT PNS and then operated by transnasal endoscopic route. Stents were placed in all patients. Patients were followed up for an average of 3.5 years (range 9 months to 5.5 years).Results: Nineteen cases were included: 24 sides were operated. No intraoperative complications were there. A restenosis rate of 29.1% (7 out of 24) was found in our series requiring revision surgery. Conclusion:Endoscopic transnasal approach is a safe and effi cacious option for treatment of choanal atresia. Use of stent in our series was not associated with high rate of restenosis.

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“…Recent studies comparing results with and without the use of stents indicate higher rates of restenosis with stenting [34,51,60,62,[68][69][70][71][72][73]. Stents were reported to induce complications: major granulation tissue formation, intranasal inflammation and infection, excoriation or erosion of the nares, columellar necrosis, septal injuries or perforation, premature extrusion, dislodgement, stent blockage, discomfort and pain [ (53,58,70,72,74,75].…”

Section: Accepted Manuscriptmentioning

confidence: 99%

“…However, referral is often delayed due to the lack of up-to-date information on therapeutic modalities available nowadays for management of CCA. The old recommendation advocated in unilateral CCA was to postpone surgery for many years [1,71] hence leaving the child with symptoms of nasal obstruction and exposed to chronic nose and paranasal sinus infection as well as to chronic serous otitis media. This explains why, in the present study, the youngest child operated for unilateral CCA was 6 days old and the oldest 13 years old.…”

Section: A C C E P T E D Accepted Manuscriptmentioning

confidence: 99%