Revision choanal atresia repair

Atresia de coana: análise de 16 casos - a experiência do HRAC-USP de 2000 a 2004

“…We used transpalatal technique in all patients, because we are skilled in this surgical technique and believe this is the best way for malformation exposure; however, literature reports that this technique is associated with longer surgical duration, larger bleeding, potential risk of bucconasal fistula, palatine dysfunction, facial growth disorder with cross bite and restenosis [1][2][3]6 . Three patients had complications after transpalatal technique: 1 bleeding, 1 palate fistula and 1 restenosis case.…”

“…Presumably, these techniques present lower bleeding risks, shorter surgery time, although they may frequently present liquor fistulas and meningitis by fracture of ethmoidal crivous lamina, restenosis and incomplete resections [1][2][3]6 . Only one patient was submitted to this technique for correction of perforation restenosis of bilateral membranous choanae along with turbinectomy, presenting postoperative bleeding and need of nasal packing.…”

“…In 1830, Otto recognized this condition as an anatomical disorder and the first surgery was performed by Emmert in 1851 [1][2][3] . It shows an incidence of 1:5,000-8,000 of live newborns, among which females are more affected than males in a 2:1 ratio.…”

“…Unilateral defects are more common than bilateral ones, while the right nostril is twice more affected than the left nostril 4,5 . Presumably, 90% of defects are of bony type, although recent literature shows that 70% of cases are mixed defects, that is, of bone-membranous type [1][2][3] . Association with other anomalies and syndromes ranges from 20 to 50%, with no genetic corroboration; the most common syndrome is CHARGE (coloboma, cardiovascular malformations, growth and mental retardation, urogenital and ear anomalies 1,4,5 ).…”

“…Association with other anomalies and syndromes ranges from 20 to 50%, with no genetic corroboration; the most common syndrome is CHARGE (coloboma, cardiovascular malformations, growth and mental retardation, urogenital and ear anomalies 1,4,5 ). There are several theories explaining choanal atresia: I -persistence of oral-pharyngeal membrane; II -failure of the physiological oral-nasal membrane rupture; III -mesodermic tissue adherence; IV -growth of palatal processes [1][2][3]6 . Diagnosis is dependent on high suspicion level.…”