title: Operative management of choanal atresia: a 15-year experience.
abstract: OBJECTIVE
  To analyze factors affecting 15-year surgical outcomes of choanal atresia repair.
  
  
  METHODS
  Case series.
  
  
  METHODS
  Tertiary care pediatric hospital.
  
  
  METHODS
  Between April 17, 1996, and March 23, 2010, a total of 42 patients aged 3 days to 15 years underwent endoscopic or transpalatal choanal atresia repair by our pediatric otolaryngology faculty.
  
  
  METHODS
  Reoperation and restenosis rates, with consideration of effects of mitomycin C therapy, stenting, and postoperative dilation.
  
  
  RESULTS
  Three of 42 patients were excluded because of inadequate follow-up data; the follow-up time for the remaining 39 patients averaged 6.3 years (range, 1-14.9 years). Excluding 6 patients whose initial repair was performed by other physicians, 31 of 33 patients in whom we performed initial repair had a total of 43 endoscopic surgical procedures (19 patients had unilateral procedures, and 12 patients had bilateral procedures), and the other 2 underwent bilateral transpalatal repair. Of the total 43 sides we operated on endoscopically, 9 sides (21%) required revision surgery, including excision of scar tissue or additional drilling of persistent bony stenosis. No significant difference was observed in the rate of restenosis among cases treated endoscopically with mitomycin C (22 of 43 operative sides, P = .13), with stenting (36 of 43 operative sides, P = .99), or with subsequent dilation (P = .45). When we used stents, they were usually (in 28 of 36 patients) left in place for 15 days or longer.
  
  
  CONCLUSIONS
  Our revision rate after initial endoscopic repair of choanal atresia was low and was unaffected by adjuvant mitomycin C therapy or stenting.
authors: Division of Otolaryngology–Head and Neck Surgery, Department of Surgery, University of Alabama atBirmingham, Birmingham, AL, USA.
authors: J Robert
authors: JR
authors: Newman
authors: Paula
authors: P
authors: Harmon
authors: W Peyton
authors: WP
authors: Shirley
authors: J Scott
authors: JS
authors: Hill
authors: Audie L
authors: AL
authors: Woolley
authors: Brian J
authors: BJ
authors: Wiatrak
mesh_terms: D000293:Adolescent; D000477:Alkylating Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D002754:Choanal Atresia / Q000601:surgery*; D004724:Endoscopy / Q000379:methods; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D016685:Mitomycin / Q000627:therapeutic use; D012008:Recurrence; D012086:Reoperation / Q000706:statistics & numerical data; D015607:Stents; D016896:Treatment Outcome
chemical_list: D000477:Alkylating Agents; D016685:Mitomycin