1. bookAHEAD OF PRINT
Journal Details
License
Format
Journal
eISSN
2286-2455
First Published
16 Apr 2016
Publication timeframe
2 times per year
Languages
English
access type Requires Authentication

Choanal Atresia – A Permanent Challenge in Rhinology Pathology

Journal Details
License
Format
Journal
eISSN
2286-2455
First Published
16 Apr 2016
Publication timeframe
2 times per year
Languages
English
Abstract

Choanal atresia is the most frequent nasal congenital malformation, which, depending on the unilateral or bilateral location, has a different symptomatology. The diagnosis is confirmed through the patient’s medical history, nasal endoscopy and imagistic examination (computed tomography). The treatment is surgical and aims the (fibrous and bone) tissue disintegration which blocks the choana, and is performed through endoscopic surgical techniques. The blocked area is maintained functional by mounting a stent at the choanal tunnel level. The authors aim to describe their own experience regarding both the diagnoses as well as the treatment of this pathology, the results being compared to those from the quoted literature. The surgical technique differs depending on the type of choanal atresia: bone or membranous. The duration to maintain a fix position of the stent and the material used for the stent represent the variables which provide the success of the endoscopic surgical intervention of the choanal atresia. Subsequently, the patient is followed up at 2, 6, 12 months in the first year and then annually until 18 years of age. Choanal atresia is solved through endoscopic surgical techniques by mounting a silicone stent which shall be maintained in position for a minimum period of 3 months. The endoscopic approach of the unilateral choanal imperforation is the method of choice with minimum complications, increased success rate and fast recovery.

Keywords

[1] A S Hengerer, T M Brickman, A Jeyakumar Choanal atresia: embryologic analysis and evolution of treatment, a 30 year experience, Laryngoscope, May 2008;118(5): 86286610.1097/MLG.0b013e3181639b91Search in Google Scholar

[2] J A Stankiewicz The endoscopic repair of choanal atresia Otolaryngology Head Neck Surgery, 103 (1990), pp. 931-93710.1177/019459989010300608Search in Google Scholar

[3] P W Flint, H B H Cummings Otolaryngology: Head and Neck Surgery, Elsevier, Philadelphia, 2015;189: 2953,2954Search in Google Scholar

[4] J L Llorente, F López, M Morato, V Suárez, A Coca, C Suárez. Tratamiento endoscópico de la atresia de coanas. Acta Otorrinolaringol Esp. 2013;64: 389–39510.1016/j.otorri.2013.05.001Search in Google Scholar

[5] J J Ballenger, J B Snow Jr Ballenger’s Otorhinolaryngology Head and Neck Surgery, 16th edition, BC Decker, Ontario, 2003;46: 1079-1080Search in Google Scholar

[6] R Wetmore, H Muntz T McGill, Pediatric Otolaryngology Principles and Practice Pathways, Second Edition, Thieme Medical Publishers, New York, 2012;25: 411, 41210.1055/b-0034-84965Search in Google Scholar

[7] F J Stucker, C de Souza, G S Kenyon, T S Lian, W Draf, B Shick Rhinology and Facial plastic surgery, Springer, Leipzig, 2009;11:133, 13410.1007/978-3-540-74380-4Search in Google Scholar

[8] K M Kwong Current Updates on Choanal Atresia Front Pediatr. 2015; 3: 52.10.3389/fped.2015.00052Search in Google Scholar

[9] A H Park, Brockenbrough J, Stankiewicz Endoscopic versus traditional approaches to choanal atresia. J Otolaryngol Clin North Am. 2000 Feb; 33(1):77-9010.1016/S0030-6665(05)70208-5Search in Google Scholar

[10] Dobrowski JM, Grundfast KM, Rosenbaum KN, Zajtchuk JT. Otorhinolaryngic manifestations of CHARGE association. Otolaryngol Head Neck Surg 1985; 93: 79880310.1177/0194599885093006193937105Search in Google Scholar

[11] P Barbero, R Valdez, H Rodríguez, C Tiscornia, E Mansilla, A Allons, S Coll, R Liascovich Choanal atresia associated with maternal hyperthyroidism treated with methimazole: A case–control study. Am J Med Genet, sept. 2008, 146A:2390–239510.1002/ajmg.a.3249718698631Search in Google Scholar

[12] A M S Kumar, A S Naik, D S Praveen Choanal Atresia: experience with transnazal endoscopic technique, Indian Journal of Otolaryngology and Head and Neck Surgert Vol. 57, no.2, April-June 2005, pp: 96-9810.1007/BF02907658345097723120140Search in Google Scholar

[13] Gujrathi, C.S et al. Management of bilateral choanal atresia in the neonate: an institutional review, International Journal of Pediatric Otorhinolaryngology, Volume 68, Issue 4, april 2004, pp. 399 – 40710.1016/j.ijporl.2003.10.00615013604Search in Google Scholar

[14] A Durmaz, F Tosun, N Yldrm, M Sahan, C Kvrakdal, M Gerek Transnasal endoscopic repair of choanal atresia: results of 13 cases and meta-analysis. J Craniofac Surg (2008) 19(5):127010.1097/SCS.0b013e318184356418812850Search in Google Scholar

[15] J E Strychowsky, K Kawai, E Moritz, R Rahbarand, E A Adil To stent or not to stent? A meta-analysis of endonasal congenital bilateral choanal atresia repair. The Laryngoscope, 2016;126: 218–22710.1002/lary.2539326014684Search in Google Scholar

[16] M Mantovani, F Mosca, M Laguardia, M Di Cicco, L Pignataro A new dynamic endonasal stent for bilateral congenital choanal atresia. Acta Otorhinolaryngologica Italica. 2009;29(4):209-212Search in Google Scholar

[17] M Hassan, T AboEl-Ezz, T Youssef. Combined transoral-transnasal approach in the repair of congenital posterior choanal atresia: clinical experience. J Otolaryngol Head Neck Surg. 2011 Jun 1. 40(3):271-6Search in Google Scholar

Recommended articles from Trend MD

Plan your remote conference with Sciendo