Management of choanal atresia

Abstract EN

Background : Choanal Atresia is a congenital disorder in which the posterior choanae unilaterally or bilaterally fail to develop properly.

The aim : To evaluate the effectiveness of the available diagnostic methods and surgical techniques for the treatment of congenital choanal atresia.

Patients and methods : A prospective study of Twenty one patients The diagnosis was based on clinical examination, and by the following : 1.

Cold spatula test. 2.

Failure of passage of 6 -8F catheter tube. 3.

CT to confirm the diagnosis and evaluate the type and thickness of the atretic plate. 4.

Endoscopic nasal examination. Results : 15 of our patients were females and6 were males with age ranging between 1 day and 25 years.

There was only one adult, the rest of our patients were children.

14 of our patients had unilateral atresia, and 7 had bilateral atresia. Eighteen of the patients showed mixed bony and membranous atresia, by CT scan, 3 cases show pure bony atresia.

There was no case with a pure membranous atresia.

Thirteen of the unilateral Choanal atresia involved the right side, and only 1 Case had left sided atresia (7.6 %).

A total of 3 cases were associated with other congenital anomalies 14 %.

All of them had bilateral choanal atresia.

Two of them were with atrial septal defect and one had ventricular septal defect.

Ten of our patients were treated by trans-nasal non-endoscopic surgical approach two of our patients treated by trans-palatal approach Nine of our patients underwent transnasal endoscopic surgical approach Stent was used postoperatively in 13 of our cases for 6 weeks.

Only 2 of our patients who underwent surgical intervention had restenosis and required revision surgery.

Conclusion : Although the transnasal endoscopic approach requires experience, special equipments and with prolonged duration of surgery, it is more accurate, minimal invasive method and provides an excellent visualization of the plate.