Transnasal Endoscopic Surgery of Choanal Atresia Without the Use of Stents

Endoscopic choanoplasty without stenting for congenital choanal atresia repair

“…However, stents cause considerable discomfort, localized infection and ulceration, circumferential scar tissue leading to restenosis after removal, and proliferation of resistant bacteria due to the necessity of long-term antibiotic therapy [27]. To avoid these complications, several recent studies have recommended using brief stenting for several days [28,29] or even not using stents at all [17,30] with comparable or even better long-term results. The argument for this way of management is that one of the advantages of using modern endoscopic repairs is the greater precision and surgical safety in fashioning the intranasal flaps, thus making it possible to cover raw edges efficiently and thus avoid the use of stents and their complications.…”

An update on choanal atresia surgery at Great Ormond Street Hospital for Children: preliminary results with Mitomycin C and the KTP laser

“…The evidence regarding Mitomycin C (an anti-neoplastic agent which inhibits fibroblasts and angioneogenesis, and therefore reduces granulation tissue formation and subsequent fibrosis) consists of small case series [8,11] and a single small comparative study (not blinded or randomised) which suggests possible benefit [12]. The use of stents is advocated by some [3][4][5]7,[12][13][14], and avoided by others [6,8,15].…”

The Effectiveness of Local Gentamicin and Dexamethasone Drops in Posterior Choanoplasty

“…Several authors even advocate endoscopic repair in an effort to be able to fashion flaps over raw areas to prevent possible postoperative stenosis. 14 The use and duration of stenting following surgical management of CA remains under significant debate in the literature. 3 Most authors agree with the use of a stent for any surgical approach, although exact duration is still controversial, ranging from 4 months 15,16 to 2 days.…”