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Article Type

Article

Abstract

Introduction: Surgery of choanal atresia aims at complete removal of the atretic plate and assurance of long term wide patency. The use of stents in the treatment of patients with choanal atresia is a controversial subject.

Material and Methods: This study included 2 groups:

First group: 20 patients with bilateral choanal atresia for whom endoscopic management together with stenting after operations was done (1998-2003). Second look operation was done for all patients.

Second group: 22 patients with bilateral choanal atresia for whom endoscopic management without stenting was done (2003-2008).

Results: First group: 20 patients (mean ages 10 days± 2days). In 4 patients the choanae remained patent after surgery, 12 patients had choanal granulation tissue, 2 patients had repeat stenosis, and 2 patients developed polyp formation, 1 patient had collumellar injury with vestibular stenosis, 1 patient developed posterior pharyngeal wall ulcer from contact with the portex tube & healed spontaneously. Second look operation was done for all patients during removal of the stent.

Second group: 22 patients (mean age 12days ±3 days). In 19 patients, the case remained patent after surgery, 7 patients had restenosis, and 1 patient had polyp in the choana.

Conclusion: Stenting should be avoided as it stimulates granulation formations and is associated with more complications. 2nd look operation appears to be mandatory with the use of the stent. Post-operative follow up to treat any complications and assure complete patency of the neochoanae is important.

Keywords: Choanal atresia, endoscopic surgery, stenting, flaps.

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