Features and Strategies in the Management of Choanal Atresia: A 6-Year Retrospective Analysis

J Craniofac Surg. 2021 Sep 1;32(6):e535-e539. doi: 10.1097/SCS.0000000000007490.

Abstract

Introduction: Choanal atresia although rare, is the most common inborn nasal deformity and an important cause of newborn airway obstruction. This study aims to describe a single-center experience in the management of choanal atresia and emphasize the ambiguous issues regarding its surgical repair.

Patients and methods: The authors retrospectively analyzed the treatment strategy of 18 patients with choanal atresia and their outcomes during the follow-up period.

Results: Bilateral choanal atresia was diagnosed in 9 patients, 6 of those had mixed bony-membranous type (67% versus 33% who had pure bony type). Almost half of the 18 patients had a mixed bony-membranous type of atresia (56%). Interestingly, 89% of patients with bilateral atresia underwent transnasal endoscopic repair with stenting, compared to 44% of those with unilateral atresia (P = 0.04). A trend to preference of stent procedure in patients with bony type was also observed, in comparison with mixed bony-membranous type (89% versus 50%, P = 0.09). No significant difference in the need for revision treatment was noticed among the two treatment groups.

Conclusions: Both in our data and literature there is no clear supremacy of stenting. Considering the high incidence of re-stenosis, all patients should be under close follow up for a long-term period. Inevitably, further investigation is necessary to establish an ideal surgical procedure.

MeSH terms

  • Choanal Atresia* / surgery
  • Constriction, Pathologic
  • Endoscopy
  • Humans
  • Infant, Newborn
  • Retrospective Studies
  • Stents
  • Treatment Outcome