title: [The application septonasal bidirectional mucoperiosteal flap in treatment of refractory choanal atresia in adults].
abstract: OBJECTIVE
  To explore the effects of septonasal bidirectional mucoperiosteal flap in the treatment of refractory choanal atresia in adults.
  
  
  METHODS
  Analysis of 9 cases for choanal atresia was conducted. Two cases were of congenital origin and 7 cases of acquired origin, which was a complication of radiotherapy for nasopharyngeal carcinoma. The patients received transnasal endoscopic surgery using the septonasal bidirectional mucoperiosteal flap, without positioning the postoperative expansion tube. After the operation, the changes of symptoms were observed and the recurrent rate of restenosis or atresia was investigated in the follow-up time.
  
  
  RESULTS
  The symptoms of nasal obstruction and mouth breathing improved significantly in the 9 patients. At an average follow-up time of 19.3 months, the new forming posterior nare remained patent. The mucoperiosteal flap had no shift or necrosis. No restenosis or atresia happened. Nasal adhesion occurred in two patients. Granulation tissue hyperplasia was found in 1 patient, who underwent endoscopic revision without recurrence.
  
  
  CONCLUSIONS
  The application of mucoperiosteal flap in transnasal endoscopic surgery for the choanal atresia can reduce the incidence of restenosis or atresia. Postoperative expansion tube is not mandatory.
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery,Yijishan Hospital,Wannan Medical College, Wuhu, 241001, China.
authors.forename: Chuanxi
authors.initials: C
authors.lastname: Wang
authors.forename: Shaofeng
authors.initials: S
authors.lastname: Liu
authors.forename: Guokang
authors.initials: G
authors.lastname: Fan
authors.forename: Beibei
authors.initials: B
authors.lastname: Yang
mesh_terms: D000328:Adult; D002277:Carcinoma; D002754:Choanal Atresia / Q000209:etiology / Q000601:surgery*; D004724:Endoscopy; D005260:Female; D006801:Humans; D006965:Hyperplasia; D008297:Male; D009296:Nasal Cavity; D015508:Nasal Obstruction / Q000209:etiology; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000532:radiotherapy; D009336:Necrosis; D011184:Postoperative Period; D011832:Radiation Injuries / Q000150:complications; D012008:Recurrence; D013524:Surgical Flaps / Q000637:transplantation*