Endoscopic transnasal repair of choanal atresia

Endoscopic choanoplasty without stenting for congenital choanal atresia repair

“…Yaniv et al [22] had a 12% (2 out of 17 patients) restenosis rate using an endoscopic technique with stents being used for 6 weeks, even though the majority of their patients were UCA cases (11 out of 17) in which we did not have any case of restenosis. Two other cases in their series developed mid-nasal synechiae both were in the UCA group.…”

“…The ideal treatment procedure for this repair should be safe, quick and simple, with minimal blood loss, a high rate of success, and minimal complications [22]. The blind transnasal puncture often provides only temporary patency, requires repeated dilations, and often needs a secondary revision with a resection technique.…”

“…He attributed his failures to inadequate vomer resection. Since this early report several authors [14][15][16][17]19,[22][23][24][25] have reported more successful use of the transnasal endoscopic approach in choanal atresia repair with refinements in both instrumentation and technique. Two technical points we find noteworthy to mention in our study are the use of the simultaneous two surgeon ''four-hand'' technique during surgery and postoperative home suction by the parents.…”

Use of a novel surgical approach for treatment of complete bilateral membranous choanal atresia in an alpaca cria

“…Nasal stenting following surgery for choanal atresia remains a highly debatable topic in human medicine. Whereas some Camelids authors believe that nasal stenting is essential to stabilize the nasal airway and reduce the likelihood of restenosis, 26 others report complications related to nasal stenting such as discomfort, localized ulceration and infection, and circumferential scar tissue formation after stent removal. 27 Recently, no difference between groups was found regarding the incidence of restenosis in 20 human patients (10/group) following transnasal endoscopic choanal atresia repair with or without the use of stents.…”

Comprehensive management of congenital choanal atresia

“…Despite the lack of standardization of the outcome measures of the series included, a certain number of surgical guidelines can be put forward that appear to reduce the risk of a restenosis. They are: to enlarge as much as possible the unineochoanae [9,25,34,[54][55][56][57], to use mucosal flaps to cover all raw surfaces [25,54,55,[57][58][59], to secure them with fibrin glue [35,55], and to avoid stenting. Addressing these rules helped the authors to achieve functionally patent choanae with one surgery in 96% of the patients.…”