Transnasal Endoscopic Repair Of Choanal Atresia
Wael Gomaa Elkelany;
Abstract
Choanal atresia is a developmental failure of the nasal cavity to communicate with the nasopharynx. It is a relatively rare congenital anomaly and occurs in approximately 1 in 5000 to 8000 live births.
With a female to male ratio of 2:1. Aspiration and asphyxia, following feeding, are common problems in these patients, as neonates are obligate nasal breathers.
Computed tomography (CT), especially axial plane, is the radiographic procedure of choice since it can demonstrate the nature (bony or membranous), position, and thickness of the obstructing segment, this helps the surgeon in designing a plan for repair.
Several surgical options are available for the repair of choanal atresia; among these are transpalatal and endoscopic approaches which are commonly used.
Transpalatal approach provides excellent visualization of the atretic plate. On the other hand, it is associated with potentially multiple complications such as injury to the greater palatine artery, palatal muscle dysfunction, and retardation of facial growth.
The endoscopic approach is simpler, safer and quicker and requires minimal tissue handling, but gives a more limited operative field to see and work within. Despite continued advances in choanal atresia surgery, restenosis of the neochoanae remains a difficult and common problem.
In our study we searched and analyzed which approach is better for management of choanal atresia and the effect of using topical Mitomycin C or nasal stent as adjuvant tool to improve the outcome of choanal atresia.
This study analyzed articles selected from 12400 articles and abstracts according to the previously selected inclusion criteria.
In this study we found that no statistically significant difference between transnasal endoscopic and transpalatal approach in repair of choanal atresia as regard restenosis or recurrence of symptoms.
Also, we found that no statistically significant difference between using intraoperative topical Mitomycin C and nasal stent or not using such modalities in the outcome of ch
With a female to male ratio of 2:1. Aspiration and asphyxia, following feeding, are common problems in these patients, as neonates are obligate nasal breathers.
Computed tomography (CT), especially axial plane, is the radiographic procedure of choice since it can demonstrate the nature (bony or membranous), position, and thickness of the obstructing segment, this helps the surgeon in designing a plan for repair.
Several surgical options are available for the repair of choanal atresia; among these are transpalatal and endoscopic approaches which are commonly used.
Transpalatal approach provides excellent visualization of the atretic plate. On the other hand, it is associated with potentially multiple complications such as injury to the greater palatine artery, palatal muscle dysfunction, and retardation of facial growth.
The endoscopic approach is simpler, safer and quicker and requires minimal tissue handling, but gives a more limited operative field to see and work within. Despite continued advances in choanal atresia surgery, restenosis of the neochoanae remains a difficult and common problem.
In our study we searched and analyzed which approach is better for management of choanal atresia and the effect of using topical Mitomycin C or nasal stent as adjuvant tool to improve the outcome of choanal atresia.
This study analyzed articles selected from 12400 articles and abstracts according to the previously selected inclusion criteria.
In this study we found that no statistically significant difference between transnasal endoscopic and transpalatal approach in repair of choanal atresia as regard restenosis or recurrence of symptoms.
Also, we found that no statistically significant difference between using intraoperative topical Mitomycin C and nasal stent or not using such modalities in the outcome of ch
Other data
| Title | Transnasal Endoscopic Repair Of Choanal Atresia | Other Titles | إصلاح الإنسداد القمعي باستخدام المنظار الأنفي | Authors | Wael Gomaa Elkelany | Issue Date | 2015 |
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