Bilateral Choanal Atresia and Endoscopic Surgery: A Chance for CHARGE Patients

Baldovin, Maria; Cazzador, Diego; Zanotti, Claudia; Frasson, Giuliana; Saratziotis, Athanasios; Pagella, Fabio; Pelucchi, Stefano; Emanuelli, Enzo

doi:10.3390/jcm10132951

Cited by 3 publications

(1 citation statement)

References 24 publications

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“…However, Baldovin M et al reported a higher rate of restenosis in stented patients with bilateral choanal atresia in the CHARGE syndrome and non-syndromic choanal atresia groups. Stented patients with non-syndromic choanal atresia required a significantly higher rate of dilations [ 19 ]. Despite the variation in restenosis rates, case reports by Kuroda Y et al, Sung JY et al, and Rahman S et al describe the use of stents to successfully treat their patients [ 6 - 8 ].…”

Section: Discussionmentioning

confidence: 99%

Surgical Management of Choanal Atresia: Two Classic Cases and Review of the Literature

Rossi¹,

Benavidez²,

Pine³

et al. 2022

Cureus

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Choanal atresia is a rare congenital airway malformation that presents a unique surgical challenge for pediatric otolaryngologists. Here we report two classic cases of choanal atresia and examine the surgical approaches to this entity. The first case was a four-day-old female with a history of CHARGE syndrome and bilateral mixed membranous and bony choanal atresia confirmed by a CT scan. After undergoing transnasal endoscopic repair, choanal stents were placed for four weeks, and the patient was seen three months postoperatively and found to be doing well with no respiratory concerns. The second case involved a healthy three-year-old female presenting with unilateral combined membranous and bony atresia. Following successful endoscopic repair, she was seen at a three-month follow-up with no signs of restenosis. Additionally, a literature review was performed to evaluate updates since the 2012 Cochrane Review on surgical treatment of congenital choanal atresia.

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Section: Discussionmentioning

confidence: 99%

Surgical Management of Choanal Atresia: Two Classic Cases and Review of the Literature

Rossi¹,

Benavidez²,

Pine³

et al. 2022

Cureus

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Choanal atresia: a review of contemporary treatment strategies

De Jong,

Heydari,

Fordham

2024

Current Opinion in Otolaryngology &Amp; Head &Amp; Neck Surgery

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Purpose of review Choanal atresia (CA) is a congenital nasal airway anomaly that, when present bilaterally, requires urgent surgical intervention. Surgical technique has evolved since its inception with most practices now favoring an endoscopic repair. Restenosis requiring revision surgery is a frequent complication, occurring in as many as 50% of cases. This review aims to highlight the most common surgical approaches, techniques used to prevent restenosis, and newer adjuncts to surgery that may improve outcomes. Recent findings Bioabsorbable, steroid-eluting stents were first developed for the adult chronic rhinosinusitis population but have been adapted for use in choanal atresia since 2017. The existing literature consists of multiple case series and one case-control study comparing these stents to traditional stents. To date, there have been no reports of restenosis or stent-related complications with these newer products. Summary Choanal atresia remains a difficult surgical pathology for which sustainable surgical results can be challenging. There is reason for optimism in bioabsorbable, steroid-eluting stents as an adjunct to CA repair if future studies expound upon their safety and efficacy.

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Successful Noninvasive Respiratory Management of an Infant with Bilateral Choanal Atresia and a Supernumerary Nostril Located on the Columella by a Mouthpiece: A Case Report

et al. 2023

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Patient: Female, Newborn Final Diagnosis: Bilateral choanal atresia and a supernumerary nostril located on the columella Symptoms: Respiratory distress Clinical Procedure: — Specialty: Pediatrics and Neonatology Objective: Rare disease Background: Choanal atresia with a supernumerary nostril located on the columella is extremely rare. Infants are obligate nasal breathers because the oral airway is invariably blocked during calm respiration. Infants breathe through the mouth only during crying, and they only have nasal breathing until 5 months of life. Congenital nasal anomalies have been reported to be fatal from birth, requiring tracheal intubation or tracheostomy in the early post-natal period. In these cases, it is crucial to maintain an adequate airway. Case Report: A 2948-g female infant was born at 40 weeks by normal vaginal delivery. Her Apgar scores were 9 and 9 at 1 and 5 min, respectively. She had retractive breathing, cyanosis, and a supernumerary nostril at birth. She had no other anomalies. Computed tomography showed bilateral membranous choanal atresia. She needed nasal continuous positive pressure or a high-flow nasal canula for oxygen desaturation during crying, apnea, and dyspnea. However, her respiratory symptoms did not improve completely. On day 25 of life, she was given a mouthpiece to support mouth breathing. Her respiratory symptoms improved gradually, and she was discharged on day 73 of life with a mouthpiece. Conclusions: A very rare case of choanal atresia with a supernumerary nostril located on the columella was described. A mouthpiece was effective for breathing, obviating the need for emergency surgical intervention in the early postnatal period. Emergency procedures were avoided, probably because this case involved incomplete bilateral membranous choanal atresia rather than complete bony atresia.

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Bilateral Choanal Atresia and Endoscopic Surgery: A Chance for CHARGE Patients

Cited by 3 publications

References 24 publications

Surgical Management of Choanal Atresia: Two Classic Cases and Review of the Literature

Surgical Management of Choanal Atresia: Two Classic Cases and Review of the Literature

Choanal atresia: a review of contemporary treatment strategies

Successful Noninvasive Respiratory Management of an Infant with Bilateral Choanal Atresia and a Supernumerary Nostril Located on the Columella by a Mouthpiece: A Case Report

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