Endoscopic repair of bilateral congenital choanal atresia.
OBJECTIVE
The literature about endoscopic repair of bilateral choanal atresia is scarce. The advantages and difficulties encountered with this technique are discussed.


METHODS
Prospective case series in a tertiary care center.


METHODS
Nine infants with bilateral choanal atresia underwent transnasal endoscopic repair. On computed tomography scans, six had mixed atresia and three had bony atresia. Extra-long burrs, ear curettes, and dissectors all have been used with 4- and 2-mm, 0 degrees telescopes. The neochoana has been stented for 5 to 8 weeks. All cases were examined with the endoscope on removal of the stent; any granulation or polyps were removed at that time.


RESULTS
Five cases remained patent after removal of stenting. Two patients required revision surgery because of repeat stenosis; one case remained patent and the other had repeat stenosis on one side. One infant died because of unrelated medical problems that occurred later. In one case the atretic tissue was thick, and the procedure was stopped because of bleeding; the infant died in the postoperative period after resuscitation.


CONCLUSIONS
Careful review of the computed tomography scan and experience with endoscopic nasal surgery makes the transnasal endoscopic treatment a safe and effective approach for managing bilateral choanal atresia.
Khafagy
Yasser W
YW
Department of Otolaryngology, Faculty of Medicine, Mansoura University, Mansoura, Egypt. ykhafagy@mum.mans.eun.eg
D002754:Choanal Atresia / Q000000981:diagnostic imaging* / Q000601:surgery*; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011446:Prospective Studies; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome