Bilateral Choanal Atresia: Is it Really a Surgical Emergency?

Abstract

To review the need of emergency recanalization surgical procedure in cases of bilateral choanal atresia. A retrospective analysis was undertaken for the cases of bilateral choanal atresia which were recanalized between January 2000 and February 2010 in a teaching hospital. Out of 135,954 live births (0.004%), six cases of bilateral choanal atresia were diagnosed and operated during this period. Five cases were hospital deliveries from our hospital whereas one case was referred from another hospital. Three cases were recanalized with dilatation procedure whereas the other three were endoscopically recanalized with micro-drill. All the cases were operated in routine operation theatre. All were managed with orogastric tube or oropharyngeal airway during the waiting period for surgery. No neonate required emergency intubation or tracheostomy. The average age at the time of surgery was 10 days (range 5-21 days). As per our observations recanalization surgery for bilateral choanal atresia is not a surgical emergency. Neonates can be managed temporarily with orogastric tube/oropharyngeal airway during waiting period. Subsequently surgery can be done in routine and unhurried operation theater by experienced surgical hands thus minimizing the morbidity.

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

“…Immediate airway management is necessary by insertion of oropharyngeal airway, orotracheal intubation or definite treatment by surgical repair. (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.…”