Impact of Successful Choanal Atresia Repair on the Nasal Mucosa: A Preliminary Study

Abstract

Introduction The main histological features of the nasal mucosa in choanal atresia are distorted cilia, marked increase of mucous submucosal glands associated with marked reduction of goblet cell density, and lymphocytic cellular infiltration. Objective To study the nasal mucosal changes in cases of choanal atresia after successful repair compared with pre-repair mucosal histological features. Methods Tissue samples were taken from the inferior turbinate of 3 patients (1 bilateral and 2 unilateral) who were successfully operated. Then, the biopsies were subjected to histopathological, histochemical and immunohistochemical studies. After that, the results were compared with pre-repair findings in the choanal atresia side and in the normal side. Results Four biopsies (4 repaired choanal atresia sides) of the mucosa of the inferior turbinate revealed that 1 patient (who had a bilateral choanal atresia repaired), after achieving a patent choana for 8 months, had not completely recovered a normal nasal mucosa. The other 2 patients, after 18 and 23 months of achieving a patent choana, showed normal nasal cavities. Conclusion The main histological features of the nasal mucosa in choanal atresia could be reversed by surgery, making the patients regain their choanal patency, with their mucosae changing back to normal gradually with time.

Combination of the endoscopic septonasal flap technique and bioabsorbable steroid-eluting stents for repair of congenital choanal atresia in neonates and infants: a retrospective study

“…Both subjective and objective assessments focused on the nasal obstruction symptoms and nasal endoscopy, respectively. Normal nasal patency was defined as a choanal aperture with < 50% restenosis using endoscopic examination and allowing normal airflow; partial restenosis was defined as anatomic stenosis > 50% and/or associated with symptoms (i.e., breathing, feeding, and growth difficulties); and complete stenosis was when no passage was visible under fibroscopy or endoscopy as previously described [ 19 ].…”

Anesthesia management in patients with choanal atresia

“…The operation for patients with unilateral CA might be delayed until school age. 2,3 In the literature, the disease has been evaluated in terms of etiopathogenesis, 4 surgical treatment approaches, 5,6 and accompanying diseases. 7 However, few articles have evaluated anesthesia management of patients with special features like CA.…”