Related Experiment Video
Updated: Jul 11, 2025
Endoscopic Septoplasty with Limited Two-line Resection: Minimally Invasive Surgery for Septal Deviation
Published on: June 20, 2018
Can a second look improve the outcome of endoscopic choanal atresia repair?
Ahmed AlKhateeb1, Danah Alrusayyis2
1Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Imam Abdulrahman Bin Faisal University, King Faisal Ibn Abd Al Aziz, Al Safa, 34212, Dammam, Saudi Arabia. aaalkhateeb@iau.edu.sa.
Purpose:
To evaluate the outcome of a routine postoperative endoscopic micro-debridement of granulation tissue after stentless transnasal endoscopic repair of choanal atresia (CA).
Methods:
This prospective case series included congenital CA patients who underwent stentless transnasal endoscopic repair, followed by an endoscopic second look and micro-debridement of granulation tissue at 1-2 weeks post-repair. Patients were followed every three months for assessment of nasal airway symptoms and objective evaluation by flexible nasolaryngoscopy.
Results:
Sixteen CA patients (8 bilateral and 8 unilateral) underwent surgical repair (12 primary and 4 revisions). The median age was 13 days (range 1 day-6 months) in bilateral and 3 years (range 7 months-15 years) in unilateral atresia. The mean follow-up was 1.5 years (range 1 year-3 years). In primary procedures, the obstruction was bony-membranous in 7 cases and bony in 5 cases. The mean interval time between the CA repair and re-examination was 10.75 days (range 6-18 days). Clinically significant neochoanal restenosis was not encountered.
Conclusions:
Re-examination under general anesthesia with endoscopic micro-debridement of granulation tissue is a safe, potentially effective adjunct when done during the proliferative phase of neochoanal wound healing. This procedure might help in maintaining neochoanal patency by remodeling tissue healing process. Large-scale, long-term cohort studies are imperative.
