Skip to main content
SpringerLink
Log in

Endoscopic management of congenital bilateral posterior choanal atresia: value of using stents

  • Rhinology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Objective of this study is to evaluate the efficacy and safety of using stents after endoscopic repair of bilateral posterior choanal atresia. Twenty cases of congenital bilateral posterior choanal atresia were managed by endoscopic transnasal approach which was performed using a nasal stent in 10 cases and without stenting in the other 10 cases. The stent was left for 4 weeks and patients had 1–5 years of follow-up. Patients have been evaluated subjectively and objectively: clinical and by endoscopic examination. Closure occurs in 20% of the stent group compared to 30% of the non-stent group, with no statistically significant difference between the two groups. On the other hand, choanal narrowing and stenosis occurs in 40% of the stent group compared to 20% of the non-stent group with a statistically significant difference between the two groups. Granulation tissue formation was detected in 50%, erosion of the nares in 10%, premature extrusion in 10%, and dislodgement in 10% of stent group. Granulation tissue formation was detected in 20%, hemorrhage occurred in 10% of the non-stent group patients. There was a statistically significant difference between the two groups (P-value  < 0.05) regarding granulation tissue formation. The use of stents after endoscopic repair of congenital bilateral posterior choanal atresia does not seem to decrease the incidence of re-closure and restenosis of the posterior choana. On the other hand, there are higher complication rate from using the stents like granulation tissue formation, excoriation or erosion of the nares, premature extrusion, dislodgement, stent blockage, and the unsightly aspect of having stents protrude from the nose.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Josephson GD, Vickery CL, Giles WC, Gross CW (1998) Transnasal endoscopic repair of congenital choanal atresia: longterm results. Arch Otolaryngol Head Neck Surg 124:537–540

    PubMed  CAS  Google Scholar 

  2. Deutsch E, Kaufman M, Eilon A (1997) Transnasal endoscopic management of choanal atresia. Int J Pediatr Otorhinolaryngol 40:19–26

    Article  PubMed  CAS  Google Scholar 

  3. Brown OE, Pownell P, Manning SC (1996) Choanal atresia: a new anatomic classification and clinical management applications. Laryngoscope 106:97–101

    Article  PubMed  CAS  Google Scholar 

  4. Leclerc JE, Fearon B (1987) Choanal atresia and associated anomalies. Int J Pediatr Otorhinolaryngol 13:265–272

    Article  PubMed  CAS  Google Scholar 

  5. Owens H (1965) Observations in treating twenty-five cases of choanal atresia by the transpalatine approach. Laryngoscope. 75:84–104

    Article  PubMed  CAS  Google Scholar 

  6. Krespi YP, Husain S, Levine TM, Reede DL (1987) Sublabial transseptal repair of choanal atresia or stenosis. Laryngoscope 97:1402–1406

    Article  PubMed  CAS  Google Scholar 

  7. Stankiewicz JA (1990) The endoscopic repair of choanal atresia. Otolaryngol Head Neck Surg 103:931–937

    PubMed  CAS  Google Scholar 

  8. Birck HG, Parrish RT (1986) The movable stent in choanal atresia. Laryngoscope 96:135–139

    Article  PubMed  CAS  Google Scholar 

  9. Grundfast KN, Thomsen JR, Barber CS (1990) An improved stent method for choanal atresia repair. Laryngoscope 100:1132–1133

    Article  PubMed  CAS  Google Scholar 

  10. Ferguson JL, Neel HB (1989) Choanal atresia: treatment trends in 47 patients over 33 years. Ann Otol Rhinol Laryngol 98:110–112

    PubMed  CAS  Google Scholar 

  11. Sadek SAA (2000) Congenital bilateral choanal atresia: a novel stenting technique in neonates. Rev Laryngol Otol Rhino 121:49–51

    CAS  Google Scholar 

  12. Abbeele TVD, Fracois M, Narcy P (2002) Transnasal endoscopic treatment of choanal atresia without prolonged stenting. Arch Otolaryngol Head Neck Surg 128:936–941

    Google Scholar 

  13. Kamel R (1994) Transnasal endoscopic approach in congenital choanal atresia. Laryngoscope 104:642–646

    Article  PubMed  CAS  Google Scholar 

  14. Singh B (1990) Bilateral choanal atresia: key to success with the transnasal approach. J Laryngol Otol 104:482–484

    Article  PubMed  CAS  Google Scholar 

  15. Richardson MA, Osguthorpe JD (1988) Surgical management of choanal atresia. Laryngoscope 98:915–918

    Article  PubMed  CAS  Google Scholar 

  16. Cumberworth VL, Diazaeri B, Mackay IS (1995) Endoscopic fenestration of choanal atresia. J Laryngol Otol 109:31–35

    PubMed  CAS  Google Scholar 

  17. Park AH, Brockenbrough J, Stankiewicz J (2000) Endoscopic versus traditional approaches to choanal atresia. Otolaryngol Clin North Am 33:77–90

    Article  PubMed  CAS  Google Scholar 

  18. Osguthorpe JD, Singleton GT, Adkins WY (1982) The surgical approach to bilateral choanal atresia: analysis of 14 cases. Arch Otolaryngol 108:366–369

    Article  PubMed  CAS  Google Scholar 

  19. Holzmann D, Ruckstuhl M (2002) Unilateral choanal atresia: surgical technique and long-term results. J Laryngol Otol 116:601–604

    Article  PubMed  Google Scholar 

  20. Samadi DS, Shah UK, Handler SD (2003) Choanal atresia: a twenty year review of medical comorbidities and surgical outcomes. Laryngoscope 113:254–258

    Article  PubMed  Google Scholar 

  21. Pasquini E, Sciarretta V, Saggese D et al (2003) Endoscopic treatment of congenital choanal atresia. Int J Pediatr Otorhinolaryngol 67:271–276

    Article  PubMed  Google Scholar 

  22. Cedin AC, Rocha JFP, Deppermann MB et al (2002) Transnasal endoscopic surgery of choanal atresia without the use of stents. Laryngoscope 112:750–752

    Article  PubMed  Google Scholar 

  23. Friedman NR, Mitchell RB, Bailey CM, Albert DM, Leighton SE (2000) Management and outcome of choanal atresia correction. Int J Pediatr Otorhinolaryngol 52:45–51

    Article  PubMed  CAS  Google Scholar 

  24. Schoem SR (2004) Transnasal endoscopic repair of choanal atresia: why stent? Otolaryngol Head Neck Surg 131:362–366

    Article  PubMed  Google Scholar 

  25. Gujrathi CS, Daniel SJ, James AL, Forte V (2004) Management of bilateral choanal atresia in the neonate: an institutional review. Int J Pediatr Otorinolaryngol 68:399–407

    Article  CAS  Google Scholar 

  26. Sharma RK, Lee CA, Gunasekaran S, Knight LC, Bielby M (2006) Stenting for bilateral congenital choanal atresia: a new technique. Int J Pediatr Otorinolaryngol 70:869–874

    Article  CAS  Google Scholar 

  27. Al-Ammar AY (2008) The use of nasal stent for choanal atresia. Saudi Med J 29(3):437–440

    PubMed  Google Scholar 

  28. Zuckerman JD, Zapata S, Sobol SE (2008) Single-stage choanal atresia repair in the neonates. Arch Otolaryngol Head Neck Surg 134:1090–1093

    Article  PubMed  Google Scholar 

  29. Cedin AC, Fujita R, Cruz OL (2006) Endoscopic transnasal surgery of choanal atresia with a stentless folded-over-flap technique. Otolaryngol Head Neck Surg 135:693–698

    Article  PubMed  Google Scholar 

  30. Bartal N (1988) An improved stent for use in the surgical management of congenital posterior choanal atresia. J Laryngol Otol 102:146–147

    Article  PubMed  CAS  Google Scholar 

Download references

Conflict of interest

The authors have no conflict of interest, financial or otherwise with any organization.

Author information

Authors and Affiliations

  1. Otolaryngology and Head and Neck Surgery, Faculty of Medicine, Tanta University Hospitals, 61 Kafr Esam Street, El Nadi Square, Tanta, Egypt

    Magdy Eisa Saafan

Authors
  1. Magdy Eisa Saafan
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Magdy Eisa Saafan.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Saafan, M.E. Endoscopic management of congenital bilateral posterior choanal atresia: value of using stents. Eur Arch Otorhinolaryngol 270, 129–134 (2013). https://doi.org/10.1007/s00405-012-1956-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-012-1956-0

Keywords

Search

Navigation