Transnasal Endoscopic Treatment of Choanal Atresia Without Prolonged Stenting

Abstract

Transnasal endoscopic repair of CA is a safe and successful technique. The use of powered instrumentation and routine postoperative revision endoscopy seems to avoid prolonged nasal stenting.

Endoscopic transnasal repair of choanal atresia

“…This rate is very good compared with the reported rates of 75% (of eight patients) [3] and 80% [18] (of 40 patients) for the endoscopic transnasal technique. Schoem [20] had no cases of restenosis, but 78% of his patients required removal of granulation tissue with a microdebrider 3-4 weeks after surgery.…”

“…More recently, Lazar and Younis [17], using transnasal endoscopy with conventional instruments, reported two failures, both in newborns with BCA. Therefore, this technique was assumed to be suitable for older children with UCA [18].…”

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

“…It has been shown that the results after transnasal surgery are comparable to those after transpalatal surgery [1], although the latter is associated with greater blood loss, longer operating time and a more prolonged recovery [2]. For the choice of surgical instruments there are no comparative data, and drills [3][4][5], microdebriders [6][7][8] and lasers [9,10] all have their advocates.…”

“…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].…”

Cirugía endoscópica en un niño con atresia unilateral de coana

“…La resección cuidadosa de la porción posterior del septum reduce la necesidad de proteger la mucosa para evitar la formación de tejido de granulación y sinarquías. Van Den Abbeele et al [15] han utilizado en sus pacientes el taponamiento nasal durante solo 2 días tras la cirugía y según sus conclusiones el taponamiento nasal no es necesario. Los resultados de la cirugía endoscopia en la atresia de coanas van desde un 75 a un 85% de éxitos según los diferentes autores [16,17].…”