Related Experiment Video
Updated: Aug 5, 2026
Endaural Endoscopic Atticoantrotomy (Retrograde Mastoidectomy) using a Constant Suction Bone-drilling Technique
Published on: May 23, 2021
[Choanal atresia--experience with early surgery]
1Ore-nese-halsavdelingen Rikshospitalet, Oslo.
Insights
The transnasal approach for choanal atresia is effective, even in younger patients. This method allows for earlier intervention, leading to successful outcomes and symptom relief in many cases.
Area of Science:
- Otolaryngology
- Pediatric Surgery
Background:
- Historically, transpalatinal approach for choanal atresia limited surgery to older children due to growth concerns.
- This retrospective study evaluates a shift in surgical strategy for choanal atresia.
Purpose of the Study:
- To assess the efficacy of the transnasal approach for choanal atresia, particularly in younger patients.
- To compare outcomes between transnasal and previous transpalatinal approaches.
Main Methods:
- A cohort of 32 patients with choanal atresia underwent the transnasal approach starting in 1982.
- Surgical intervention was performed as soon as symptoms manifested, often at an earlier age.
- Specific techniques included removal of the posterior vomer in some cases.
Main Results:
- For bilateral choanal atresia, 9 of 14 patients operated before two months of age showed positive outcomes.
- In unilateral atresia, 7 of 11 patients operated before seven years were successful, and 6 of 7 operated after seven remained symptom-free.
- Recurrence of symptoms was noted in 3 patients with bilateral atresia.
Conclusions:
- The transnasal approach is a viable and effective surgical option for choanal atresia.
- Early surgical intervention via the transnasal route is recommended when symptoms are distressing, irrespective of patient age.
Introduction:
Prior to 1982, patients in our department with choanalatresia were operated by the transpalatinal approach. To eliminate the risk of insufficient transpalatine growth, only older children were operated.
Material And Methods:
From 1982 we have chosen to operate as soon as symptoms occurred, usually at an earlier age. Therefore, we chose the transnasal approach in 32 patients.
Results:
Of 14 patients with bilateral choanalatresia, nine were operated before two months of age. In nine patients we took care to remove some of the posterior part of vomer. Four of them have been symptom free for more than a year, an additional two symptom free but with an observation period of less than a year, and three have renewed symptoms. Of 18 patients with unilateral atresia, 11 were operated before seven years of age, seven of them successfully. Of the seven operated after the age of seven, six are symptom free.
Interpretations:
We believe that these results justify continuing with transnasal operations as soon as symptoms are distressing, regardless of age.
