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Management of choanal atresia in cases of craniofacial malformation

Martin Stieve1, H G Kempf, Th Lenarz

  • 1Department of Otolaryngology, Medical University of Hannover, Hannover, Germany ; Department of Otolaryngology, Medical University of Hannover, Carl-Neuberg-Str. 1, D-30625 Hannover, Germany.

Journal of Maxillofacial and Oral Surgery
|November 10, 2012
PubMed

Insights

Endonasal endoscopic surgery effectively treats congenital choanal atresia in infants with craniofacial malformations. This minimally invasive approach reduces surgical trauma and bleeding risk, with restenosis minimized through proper fixation and care.

Area of Science:

  • Otolaryngology
  • Pediatric Surgery
  • Medical Engineering

Background:

  • Congenital choanal atresia presents a significant challenge, particularly in infants with complex craniofacial malformations.
  • This condition necessitates prompt and effective surgical intervention to ensure adequate respiration and feeding.

Purpose of the Study:

  • To detail the methodology and outcomes of the endonasal endoscopic approach for congenital choanal atresia.
  • To evaluate the efficacy of this technique in infants and children, including those with severe craniofacial anomalies.

Main Methods:

  • Utilized computed tomography (CT) scans for diagnosis and intraoperative endoscopy to assess atresia type (membranous or osseous).
  • Employed trocars and diamond drills for atresia plate and osseous portion removal, followed by transnasal silicone tube insertion for several months.
  • Surgical intervention was performed immediately after birth for bilateral atresia cases and later for unilateral cases.

Main Results:

  • The endonasal endoscopic approach was successful in treating seven pediatric patients with choanal atresia between 1999 and 2006.
  • While tube dislodcations required adjustments in bilateral cases, no further stenoses were observed post-tube removal (3-6 months).
  • One case of septal perforation was noted, but overall outcomes were positive post-intervention.

Conclusions:

  • The transnasal endoscopic approach offers a minimally invasive option for newborns and infants, characterized by low surgical trauma and reduced bleeding risk.
  • Effective management of restenosis is achievable through adequate tube fixation and comprehensive inpatient care.
Abstract

Keywords:
Choanal atresiaCraniofacial malformationSurgical procedure

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