Choanal Atresia Repair Using Mucoperiosteal Flaps Without Stenting: 10-Year Experience

Area of Science:

• Craniofacial surgery
• Pediatric otolaryngology
• Endoscopic airway surgery

Background:

• Congenital choanal atresia (CCA) is a rare craniofacial anomaly with variable presentation.
• Endoscopic endonasal repair is the standard treatment for CCA.
• Limited data exists on long-term outcomes and revision predictors after endoscopic CCA repair.

Purpose of the Study:

• To evaluate clinical characteristics and surgical outcomes of endoscopic endonasal CCA repair.
• To identify predictors of revision surgery in pediatric patients undergoing CCA repair.
• To assess long-term functional outcomes and neochoanal patency after endoscopic CCA repair without stenting.

Main Methods:

• Retrospective single-center study of pediatric patients (≤18 years) undergoing unilateral or bilateral CCA repair between 2015-2025.
• Analysis of surgical technique, perioperative complications, and long-term functional outcomes.
• Focus on endoscopic endonasal repair utilizing mucosal flaps without stenting.

Main Results:

• Thirty-six patients (23 unilateral, 13 bilateral CCA) underwent repair.
• Postoperative complications included granulation tissue (22%), synechiae (33%), and restenosis (39%).
• The relook surgery rate was 47%, primarily within the first postoperative month; 97% achieved long-term neochoanal patency.

Conclusions:

• Endoscopic endonasal CCA repair demonstrates excellent long-term patency with low overall morbidity.
• Restenosis and the need for relook surgery are common challenges.
• Vigilant postoperative follow-up and optimized management strategies are crucial for successful CCA treatment.