Clinical retrospective analysis of 15 cases of choanal atresia – Our experience

Objective: Choanal atresia is a rare congenital disorder due to failed recanalization of the nasal fossae during fetal development. This article focuses on our experience in dealing with choanal atresia and its management. Here we discuss the varied clinical symptoms that the patients presented with...

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Autores principales:	Segana Hasan Abdul Cader, Fahim Ahmed Shah, Nair Reghunandanan
Formato:	article
Lenguaje:	EN
Publicado:	KeAi Communications Co., Ltd. 2019
Materias:	Otorhinolaryngology RF1-547 Surgery RD1-811
Acceso en línea:	https://doaj.org/article/7f0c3d30854648dd9f619cd665332f2f
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spelling	oai:doaj.org-article:7f0c3d30854648dd9f619cd665332f2f2021-12-02T14:22:03ZClinical retrospective analysis of 15 cases of choanal atresia – Our experience2095-881110.1016/j.wjorl.2019.03.003https://doaj.org/article/7f0c3d30854648dd9f619cd665332f2f2019-12-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2095881118301525https://doaj.org/toc/2095-8811Objective: Choanal atresia is a rare congenital disorder due to failed recanalization of the nasal fossae during fetal development. This article focuses on our experience in dealing with choanal atresia and its management. Here we discuss the varied clinical symptoms that the patients presented with, the clinical tests and investigations that were specific in diagnosing this condition and surgical management of these cases with endoscopic transnasal choanaplasty with stenting and follow up topical Mitomycin C application. Material and methods: This is a retrospective study based on computerized medical record review of the patients born in Department of ENT of Sur Hospital between 2002 and 2017. The patients were assessed with detailed history, presentation of clinical symptoms and all underwent nasal endoscopy and CT scans for assessing the atretic type. These patients underwent transnasal endoscopic choanaplasty under general anesthesia using microdebrider and stented using endotracheal tube. The patients were regularly followed up for review with nasal endoscopy after discharge between 4th and 7th postoperative period. The parents were educated on nursing care and the stent was removed in 4 weeks, all patients had Mitomycin C applied to the neochoana and were on regular follow up for a year with no recurrence. Results: Fifteen patient records were analyzed, 10 females and 5 males, ages varying from newborns up to 14 years old. Unilateral to bilateral choanal atresia was 4:1 ratio and female-male showed 2:1 ratio. Right malformation was predominant in both sexes in unilateral atresia. Mixed imperforation (bone-membranous) was the most frequently observed type, followed by bone malformation. The commonest symptom during diagnosis was rhinorrhea and the least one was respiratory failure. Majority of cases were diagnosed by CT scans of sinuses. Around 10% patients presented with cardiac problems. None had restenosis in one year follow up. Conclusions: Neonates with acute respiratory insufficiency due to choanal atresia can be diagnosed with simple bedside tests like cold spatula test, less invasive tests like failure to pass intranasal catheter, CT scan. Surgical correction with endoscopic intranasal choanaplasty is the way to address this problem and could avoid radical palatal approach, less morbidity and high success rate. Keywords: Choanal atresia, Congenital, StentSegana Hasan Abdul CaderFahim Ahmed ShahNair ReghunandananKeAi Communications Co., Ltd.articleOtorhinolaryngologyRF1-547SurgeryRD1-811ENWorld Journal of Otorhinolaryngology-Head and Neck Surgery, Vol 5, Iss 4, Pp 188-192 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	Otorhinolaryngology RF1-547 Surgery RD1-811
spellingShingle	Otorhinolaryngology RF1-547 Surgery RD1-811 Segana Hasan Abdul Cader Fahim Ahmed Shah Nair Reghunandanan Clinical retrospective analysis of 15 cases of choanal atresia – Our experience
description	Objective: Choanal atresia is a rare congenital disorder due to failed recanalization of the nasal fossae during fetal development. This article focuses on our experience in dealing with choanal atresia and its management. Here we discuss the varied clinical symptoms that the patients presented with, the clinical tests and investigations that were specific in diagnosing this condition and surgical management of these cases with endoscopic transnasal choanaplasty with stenting and follow up topical Mitomycin C application. Material and methods: This is a retrospective study based on computerized medical record review of the patients born in Department of ENT of Sur Hospital between 2002 and 2017. The patients were assessed with detailed history, presentation of clinical symptoms and all underwent nasal endoscopy and CT scans for assessing the atretic type. These patients underwent transnasal endoscopic choanaplasty under general anesthesia using microdebrider and stented using endotracheal tube. The patients were regularly followed up for review with nasal endoscopy after discharge between 4th and 7th postoperative period. The parents were educated on nursing care and the stent was removed in 4 weeks, all patients had Mitomycin C applied to the neochoana and were on regular follow up for a year with no recurrence. Results: Fifteen patient records were analyzed, 10 females and 5 males, ages varying from newborns up to 14 years old. Unilateral to bilateral choanal atresia was 4:1 ratio and female-male showed 2:1 ratio. Right malformation was predominant in both sexes in unilateral atresia. Mixed imperforation (bone-membranous) was the most frequently observed type, followed by bone malformation. The commonest symptom during diagnosis was rhinorrhea and the least one was respiratory failure. Majority of cases were diagnosed by CT scans of sinuses. Around 10% patients presented with cardiac problems. None had restenosis in one year follow up. Conclusions: Neonates with acute respiratory insufficiency due to choanal atresia can be diagnosed with simple bedside tests like cold spatula test, less invasive tests like failure to pass intranasal catheter, CT scan. Surgical correction with endoscopic intranasal choanaplasty is the way to address this problem and could avoid radical palatal approach, less morbidity and high success rate. Keywords: Choanal atresia, Congenital, Stent
format	article
author	Segana Hasan Abdul Cader Fahim Ahmed Shah Nair Reghunandanan
author_facet	Segana Hasan Abdul Cader Fahim Ahmed Shah Nair Reghunandanan
author_sort	Segana Hasan Abdul Cader
title	Clinical retrospective analysis of 15 cases of choanal atresia – Our experience
title_short	Clinical retrospective analysis of 15 cases of choanal atresia – Our experience
title_full	Clinical retrospective analysis of 15 cases of choanal atresia – Our experience
title_fullStr	Clinical retrospective analysis of 15 cases of choanal atresia – Our experience
title_full_unstemmed	Clinical retrospective analysis of 15 cases of choanal atresia – Our experience
title_sort	clinical retrospective analysis of 15 cases of choanal atresia – our experience
publisher	KeAi Communications Co., Ltd.
publishDate	2019
url	https://doaj.org/article/7f0c3d30854648dd9f619cd665332f2f
work_keys_str_mv	AT seganahasanabdulcader clinicalretrospectiveanalysisof15casesofchoanalatresiaourexperience AT fahimahmedshah clinicalretrospectiveanalysisof15casesofchoanalatresiaourexperience AT nairreghunandanan clinicalretrospectiveanalysisof15casesofchoanalatresiaourexperience
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Clinical retrospective analysis of 15 cases of choanal atresia – Our experience

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