Background: This study was designed to investigate the role of endoscopic surgery for acquired choanal atresia after radiotherapy for nasopharyngeal carcinoma.
Methods: Twenty-two patients with bilateral or unilateral acquired choanal atresia received transnasal endoscopic surgery with the aid of a powered microdebrider to open atresia choana and received endoscopic sinus surgery simultaneously if they had sinusitis. Merocel epistaxis packing was used to pack the nasal airway for 3 days postoperatively. All of the patients underwent endoscopy regularly for follow-up.
Results: Sixteen patients with acquired bilateral choanal atresia and 6 with unilateral choanal atresia were included in this study. The median age was 46 years old (range, 33-65 years). Twenty-one patients had sinusitis. Sixteen patients with bilateral choanal atresia and 4 patients with unilateral atresia had bilateral sinusitis. One patient with unilateral atresia had ipsilateral sinusitis. The mean follow-up period was 35 months (range, 12-72 months) after surgery. Twenty patients were symptom-free after a single operation; nasal obstruction, rhinorrhea, and xerostomia improved significantly for these patients. Two patients had unilateral restenosis that required revision surgery, and both were subsequently free from further restenosis. No complications occurred.
Conclusion: Acquired posterior choanal atresia after radiotherapy can be successfully treated with transnasal endoscopic resection assisted by a powered instrument without stenting.