A 20-Year Experience in Microsurgical Treatment of Choanal Atresia

Endoscopic Repair of Congenital Choanal Atresia without Stenting at Queen Rania Pediatric Hospital

“…Bilateral atresia presents early with respiratory distress while unilateral atresia may remain asymptomatic until first upper respiratory tract infection develops. (8) It is more common in females, (3) in our study we also found that females (75%) are more affected than males (25%), although some studies showed no gender difference, as in a study done by Hengerer AS, et al on 73 patients. (9) In unilateral cases higher prevalence was found in the right side, (1) also in our study right side was involved in 62% of patients.…”

“…(2) Although it is a rare condition, it is the most common congenital nasal malformation with incidence of one in every 8000-10000 live births. (3) It was first described by Johann Roederer in 1755. Females are affected more than males.…”

“…(6) Unilateral cases may remain undetected till late adulthood with symptoms of nasal obstruction and mucoid nasal secretions. (3) Its composition may be bony, membranous or mixed (bony and membranous) which is the most common type. (7) Many surgical approaches have been used with endoscopic transnasal being the most preferred.…”

Comprehensive management of congenital choanal atresia

“…Recent studies comparing results with and without the use of stents indicate higher rates of restenosis with stenting [34,51,60,62,[68][69][70][71][72][73]. Stents were reported to induce complications: major granulation tissue formation, intranasal inflammation and infection, excoriation or erosion of the nares, columellar necrosis, septal injuries or perforation, premature extrusion, dislodgement, stent blockage, discomfort and pain [ (53,58,70,72,74,75]. Prolonged mucosal trauma around stents stimulates scar tissue formation, especially circumferential scar, thereby increasing the risk of restenosis [35,55,57].…”

“…Immediate postoperative extubation, early start of breast-suction and shorter hospital stay [31,[33][34][35][36]62,74] should become part of the standard objectives of the choanal atresia repair. However, hospitalization time in newborns with bilateral CCA can be prolonged because of the vulnerability of a newborn for total nasal blockage, as can happen in the early postoperative period due to accumulation of secretions, clots or crust.…”