The efficacy of mitomycin and stenting in choanal atresia repair: A 20 year experience

Comprehensive management of congenital choanal atresia

“…This confirms that appropriate postoperative nasal care is of the utmost importance in avoiding recurrences [1,34]. It has been advocated to use systematic prevention of extra-esophageal reflux [1,34,53], cleaning with saline, careful aspiration, and application of topical steroids [34,35,62], which is consistent with the author's experience. Furthermore, in the present study, it appeared necessary to keep using topical steroids for a minimum of 8 months after the surgery to prevent scar formation.…”

“…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].…”

“…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.…”

Current Updates on Choanal Atresia

“…Studies in early 2000s showed improved surgical outcome of CA repair with mitomycin C use ( 41 , 42 ). However, none of those studies had a proper control group to demonstrate the improved surgical outcome was caused by the use of mitomycin C. Subsequent studies failed to show significant difference in restenosis rate between the mitomycin group and the control group ( 43 – 45 ). Similarly, Carter et al in their recent study had the same conclusion about restenosis rate while showing decreased granulation tissue formation and fewer subsequent surgical debridements with topical mitomycin C treatment ( 45 ).…”

Comprehensive review on endonasal endoscopic sinus surgery

“…The majority of single publications and review articles do not see a benefit in the insertion of stents [ 648 ], [ 649 ], [ 650 ], [ 652 ], [ 661 ], [ 662 ], [ 663 ], [ 664 ], [ 665 ]. In contrast, there are even new disadvantages.…”