Korean J Otolaryngol-Head Neck Surg.
2000 Mar;43(3):296-299.
Congenital Choanal Atresia : Analysis of 7 Cases
- Affiliations
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- 1Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, korea. jhyoon@yumc.yonsei.ac.kr
Abstract
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BACKGROUND AND OBJECTIVES:Congenital choanal atresia is a relatively uncommon disease whose causes can be explained by embryological etiology. To date, many authors have expressed various opinions about the timing of surgery and surgical approach. We retrospectively analyzed 7 cases of congenital choanal atresia patients to report the treatment results and to propose the timing of surgery and method of surgical approach.
MATERIALS AND METHODS
Seven congenital choanal atresia patients who had been treated between 1981 to 1997 were retrospectively analyzed with chart and X-ray review. The symptoms, associated anomalies, site of atresia, features of the atretic plate, surgical approaches, duration and materials for stenting, reoperation, duration and results of follow-up were analyzed. Five patients were female and 2 patients were male. Associated anomalies were observed in 1 case (14%). Of the 6 patients who underwent surgery, the transnasal approach was used in 3 cases and the transpalatal approach was used in 3 cases. The atretic site was bilateral in 5 cases (71%) and unilateral in 2 cases (29%). Stent was used in all surgical cases.
RESULTS
Bony atresia was observed in 3 sides (30%), membranous atresia in 2 sides (20%), and mixed bony-membranous atresia in 5 sides (50%) out of 10 sides evaluable. Three patients who were treated by transpalatal approach and 1 patient who was treated by transnasal approach were successfully treated without reoperation. Two newborn patients who were treated by transnasal approach could achieve normal growth and development due to mouth feeding and nasal breathing. They had granulation tissue or stenosis of the opening but they were successfully treated by reoperation and longer period of stenting.
CONCLUSION
We recommend neonatal congenital choanal atresia patient would be better to be treated by transnasal approach with longer period of stenting as soon as possible right after diagnosis.