The endoscopic transseptal approach for choanal atresia repair

Wormald, Peter‐John; Zhao, Yi; Valdés, Constanza J.; Pacheco, Alvaro E.; Ha, Thanh Ngoc; Tewfik, Marc A.; Wabnitz, David; Shaw, Chi‐Kee Leslie

doi:10.1002/alr.21716

Cited by 29 publications

(19 citation statements)

References 28 publications

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“…The transseptal approach to repair CA without the use of stents was reported by Wormald et al [24] in 16 pediatric patients and one adult patient. In total, seven cases were bilateral, and 10 were unilateral.…”

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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“…Choanal atresia (CA) is a congenital condition resulting in obstruction of the posterior nasal passage(s), known as the choana, with an incidence of approximately one in 5000 to 8000 live births [ 1 , 2 ]. Management of CA involves surgical resection of the atretic plate and surrounding structures [ 3 ]. The most common approaches to surgical repair of CA include endoscopic transnasal (ETN), non-endoscopic transnasal (NTN), and transpalatal (TP), with the ETN being the currently favored approach [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

A national study of choanal atresia in tertiary care centers in Canada – part II: Clinical management

Paradis

Dzioba

El-Hakim

et al. 2021

Journal of Otolaryngology - Head & Neck Surgery

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Background To evaluate the clinical management of choanal atresia (CA) in tertiary centers across Canada. Methods Multi-centre case series involving six tertiary care pediatric hospitals across Canada. Retrospective chart review of patients born between 1980 and 2010 diagnosed with choanal atresia to a participating center. Results The health charts of 215 patients (59.6% female) with choanal atresia (CA) were reviewed. Mean age of initial surgical repair was 0.8 months for bilateral CA, and 48.6 months for unilateral CA. Approaches of surgical repair consisted of endoscopic transnasal (31.7%), non-endoscopic transnasal (42.6%), and transpalatal (25.2%). Stents were used on 70.7% of patients. Forty-nine percent of patients were brought back to the OR for a planned second look; stent removal being the most common reason (86.4%). Surgical success rate of initial surgeries was 54.1%. Surgical technique was not associated with rate of restenosis [χ2 (2) = 1.6, p = .46]. Conclusions The present study is the first national multi-institutional study exploring the surgical outcomes of CA over a 30-year period. The surgical repair of CA presents a challenge to otolaryngologists, as the rate of surgical failure is high. The optimal surgical approach, age at surgical repair, use of stents, surgical adjuncts, and need for planned second look warrant further investigation. Graphical abstract

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“…Generally, choanal atresia may affect one or both Choanae, although most studies show that the unilateral form is more common than the bilateral one [ 2 , 3 ], and the incidence is higher in females than in males (2:1) [ 4 , 5 ]. The unilateral form is frequently on the right side [ 2 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Radiological Parameters Review for Choanal Atresia

et al. 2021

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(1) Background: The study aims to identify which imaging parameters are necessary for a new correct surgical approach in the study of choanal atresia, and which anatomical findings are essential for correct planning of endoscopic treatment in choanal atresia. (2) Methods: In this retrospective study, 19 patients with choanal atresia had high-resolution multiplanar imaging (14 cases aged ≤1 year and 5 cases aged 1 to 3 years) and 35 patients in the control group similarly distributed by age. Fourteen variables, the most relevant from a surgical point of view, were selected and measured. A comparison was made between the averages of the study group and the different control groups, either directly observed or selected from the literature, using Pearson’s correlation. (3) Results: In 14 out of 26 cases, the differences were statistically significant. There was a correlation between the structures assessed, such as choanal height, rostrum height, and age. (4) Conclusions: Thanks to volumetric reformatting, this work identified and provided the clinician with useful information that helped choose the correct surgical approach. Furthermore, it focused on which imaging parameters are necessary to improve the planning of the surgical correction of choanal atresia.

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The endoscopic transseptal approach for choanal atresia repair

Abstract: This novel endoscopic transseptal repair technique is effective in the management of choanal atresia. Careful fashioning of mucosal flaps and the omission of stenting has resulted in lasting patency of the neochoanae.

Cited by 29 publications

References 28 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?

A national study of choanal atresia in tertiary care centers in Canada – part II: Clinical management

Radiological Parameters Review for Choanal Atresia

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