Choanal atresia (CA) is a rare occlusion of the posterior choanae. Unilateral cases have been reported more than bilaterally, and it’s more often right-sided in those patients. According to the literature, mixed bony...Choanal atresia (CA) is a rare occlusion of the posterior choanae. Unilateral cases have been reported more than bilaterally, and it’s more often right-sided in those patients. According to the literature, mixed bony-membranous atresia is the most common type. There is a high incidence of craniofacial and visceral anomalies associated with congenital choanal atresia. Therefore, investigation for associated congenital anomalies is an important step before the surgery. We report 2 cases of incidental finding of unilateral choanal atresia in a 21- and 17-year-old with nasal discharge being the only complaint in the former and nasal obstruction with headache in the latter. The patients were then scheduled for day-surgery as a case of choanal atresia for transnasal, endoscopic repair and posterior septectomy. The patients were discharged home on the same day with the absence of restenosis or other complications.展开更多
Objective: Choanal atresia is a rare congenital disorder due to failed recanalization of the nasal fossae during fetal development.This article focuses on our experience in dealing with choanal atresia and its managem...Objective: Choanal atresia is a rare congenital disorder due to failed recanalization of the nasal fossae during fetal development.This article focuses on our experience in dealing with choanal atresia and its management.Here we discuss the varied clinical symptoms that the patients presented with,the clinical tests and investigations that were specific in diagnosing this condition and surgical management of these cases with endoscopic transnasal choanaplasty with stenting and follow up topical Mitomycin C application.Material and methods: This is a retrospective study based on computerized medical record review of the patients born in Department of ENT of Sur Hospital between 2002 and 2017.The patients were assessed with detailed history,presentation of clinical symptoms and all underwent nasal endoscopy and CT scans for assessing the atretic type.These patients underwent transnasal endoscopic choanaplasty under general anesthesia using microdebrider and stented using endotracheal tube.The patients were regularly followed up for review with nasal endoscopy after discharge between 4th and 7th postoperative period.The parents were educated on nursing care and the stent was removed in 4 weeks,all patients had Mitomycin C applied to the neochoana and were on regular follow up for a year with no recurrence.Results: Fifteen patient records were analyzed,10 females and 5 males,ages varying from newboms up to 14 years old.Unilateral to bilateral choanal atresia was 4:1 ratio and female-male showed 2:1 ratio.Right malformation was predominant in both sexes in unilateral atresia.Mixed imperforation (bone-membranous) was the most frequently observed type,followed by bone malformation.The commonest symptom during diagnosis was rhinorrhea and the least one was respiratory failure.Majority of cases were diagnosed by CT scans of sinuses.Around 10% patients presented with cardiac problems.None had restenosis in one year follow up.Conclusions: Neonates with acute respiratory insufficiency due to choanal atresia can be diagnosed with simple bedside tests like cold spatula test,less invasive tests like failure to pass intranasal catheter,CT scan.Surgical correction with endoscopic intranasal choanaplasty is the way to address this problem and could avoid radical palatal approach,less morbidity and high success rate.展开更多
Background There are congenital and acquired choanal atresias and many approaches have been used for their repair. We assessed the clinical effect of power instrument, endoscopic repair of acquired choanal stenosis an...Background There are congenital and acquired choanal atresias and many approaches have been used for their repair. We assessed the clinical effect of power instrument, endoscopic repair of acquired choanal stenosis and atresia. Methods Nineteen patients, aged from 32 to 61 years, with acquired choanal stenosis and atresia （from trauma in 5 cases and from radiotherapy after nasopharyngeal carcinoma in 14; 6 bilateral and 13 unilateral cases）, underwent transnasal endoscopic repair of choanal stenosis and atresia. No patient had stenting. Antibiotic and local glucocorticoid were administered postoperatively.Results Eighteen patients remained free of symptoms for 12-40 months after the surgery, and the diameter of the neochoana was more than 1 cm after the procedure. One patient required revision surgery and recovered completely with no restenosis at 12 months after the second surgery. There were no postoperative complications. Histology of the resected tissue revealed respiratory epithelial-lined stromal tissue with chronic inflammation, edema and fibrosis, but no tumor cells.Conclusions Transnasal endoscopic approach is a useful procedure for the repair of acquired choanal stenosis and atresia： it is highly successful, safe and effective with swift recovery and short time of hospitalization. It is very important in postoperative care to remove any granulation or polyps at the site of the neochoana at that time.展开更多
文摘Choanal atresia (CA) is a rare occlusion of the posterior choanae. Unilateral cases have been reported more than bilaterally, and it’s more often right-sided in those patients. According to the literature, mixed bony-membranous atresia is the most common type. There is a high incidence of craniofacial and visceral anomalies associated with congenital choanal atresia. Therefore, investigation for associated congenital anomalies is an important step before the surgery. We report 2 cases of incidental finding of unilateral choanal atresia in a 21- and 17-year-old with nasal discharge being the only complaint in the former and nasal obstruction with headache in the latter. The patients were then scheduled for day-surgery as a case of choanal atresia for transnasal, endoscopic repair and posterior septectomy. The patients were discharged home on the same day with the absence of restenosis or other complications.
文摘Objective: Choanal atresia is a rare congenital disorder due to failed recanalization of the nasal fossae during fetal development.This article focuses on our experience in dealing with choanal atresia and its management.Here we discuss the varied clinical symptoms that the patients presented with,the clinical tests and investigations that were specific in diagnosing this condition and surgical management of these cases with endoscopic transnasal choanaplasty with stenting and follow up topical Mitomycin C application.Material and methods: This is a retrospective study based on computerized medical record review of the patients born in Department of ENT of Sur Hospital between 2002 and 2017.The patients were assessed with detailed history,presentation of clinical symptoms and all underwent nasal endoscopy and CT scans for assessing the atretic type.These patients underwent transnasal endoscopic choanaplasty under general anesthesia using microdebrider and stented using endotracheal tube.The patients were regularly followed up for review with nasal endoscopy after discharge between 4th and 7th postoperative period.The parents were educated on nursing care and the stent was removed in 4 weeks,all patients had Mitomycin C applied to the neochoana and were on regular follow up for a year with no recurrence.Results: Fifteen patient records were analyzed,10 females and 5 males,ages varying from newboms up to 14 years old.Unilateral to bilateral choanal atresia was 4:1 ratio and female-male showed 2:1 ratio.Right malformation was predominant in both sexes in unilateral atresia.Mixed imperforation (bone-membranous) was the most frequently observed type,followed by bone malformation.The commonest symptom during diagnosis was rhinorrhea and the least one was respiratory failure.Majority of cases were diagnosed by CT scans of sinuses.Around 10% patients presented with cardiac problems.None had restenosis in one year follow up.Conclusions: Neonates with acute respiratory insufficiency due to choanal atresia can be diagnosed with simple bedside tests like cold spatula test,less invasive tests like failure to pass intranasal catheter,CT scan.Surgical correction with endoscopic intranasal choanaplasty is the way to address this problem and could avoid radical palatal approach,less morbidity and high success rate.
文摘Background There are congenital and acquired choanal atresias and many approaches have been used for their repair. We assessed the clinical effect of power instrument, endoscopic repair of acquired choanal stenosis and atresia. Methods Nineteen patients, aged from 32 to 61 years, with acquired choanal stenosis and atresia （from trauma in 5 cases and from radiotherapy after nasopharyngeal carcinoma in 14; 6 bilateral and 13 unilateral cases）, underwent transnasal endoscopic repair of choanal stenosis and atresia. No patient had stenting. Antibiotic and local glucocorticoid were administered postoperatively.Results Eighteen patients remained free of symptoms for 12-40 months after the surgery, and the diameter of the neochoana was more than 1 cm after the procedure. One patient required revision surgery and recovered completely with no restenosis at 12 months after the second surgery. There were no postoperative complications. Histology of the resected tissue revealed respiratory epithelial-lined stromal tissue with chronic inflammation, edema and fibrosis, but no tumor cells.Conclusions Transnasal endoscopic approach is a useful procedure for the repair of acquired choanal stenosis and atresia： it is highly successful, safe and effective with swift recovery and short time of hospitalization. It is very important in postoperative care to remove any granulation or polyps at the site of the neochoana at that time.
