Patients With Congenital Choanal Atresia Treated by Transnasal Endoscopic Surgery

Abstract

Congenital choanal atresia (CCA) is defined as a congenital failure in the development of communication between the nasal cavity and nasopharynx in newborns. It is the most common congenital anomaly of nose. Most of the patients presented with unilateral CCA. Neonates with bilateral CCA have severe respiratory distress after birth. Airway control with orotracheal intubation should be done immediately to save the life of neonate with bilateral CCA. After airway control, surgery should be performed as soon as possible. The aim of surgery is to create a patent nasal passage and to prevent restenosis with minimal morbidity. Transnasal endoscopic surgery of CCA has become the most popular treatment method. The retrospective review of 33 patients with CCA was presented in this study. The patients who were diagnosed at the neonate period and operated on in 6 months after birth were grouped as I (neonate). The patients who were diagnosed 6 months after birth were grouped as II (child-young adult). All patients were treated by transnasal endoscopic surgery. Stent were put in all patients to prevent restenosis. Although the restenosis rate was higher in group I (53.8%) than in group II (23.1%), it did not cause a statistically significant difference. Overall success rate of our surgical approach was 61.5%. Despite the surgical developments and many treatment modalities, restenosis is still the most challenging problem in CCA.

To stent or not to stent? A meta‐analysis of endonasal congenital bilateral choanal atresia repair

“…The remaining 84 full‐text articles were reviewed in their entirety. Fifteen studies (n = 215 patients) satisfied the inclusion criteria and were included in the analysis . Four studies compared outcomes for patients who were stented postoperatively versus those who were not stented .…”

“…Four studies compared outcomes for patients who were stented postoperatively versus those who were not stented . Thirteen studies reported outcomes on patients who were stented; six studies reported outcomes on patients who were not stented . OCEBM levels of evidence varied from level 3 (one study) to 4 (14 studies) .…”

“…Thirteen studies (n = 173 patients; Fig. ) included patients who were stented; the weighted pooled proportion of successful surgery was 65% (95% confidence interval [CI], 49–79%) . Six studies (n = 42) evaluated patients who were not stented; the weighted pooled proportion of successful surgery was 64% (95% CI, 42–84%).…”

“…The mean duration of stenting ranged from 2 days to 16 weeks . We considered a stent duration of 7 days or less as short‐term stenting versus stenting for longer than 7 days as long‐term stenting.…”

“…Patients with CHARGE syndrome were included in six studies . The majority of studies did not report outcomes separately for those with CHARGE syndrome . One study reported surgical success for patients with and without the syndrome .…”