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Vol. 64. Issue 6.
Pages 389-395 (November - December 2013)
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Vol. 64. Issue 6.
Pages 389-395 (November - December 2013)
Original Article
DOI: 10.1016/j.otoeng.2013.11.006
Endoscopic Treatment of Choanal Atresia
Tratamiento endoscópico de la atresia de coanas
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José Luis Llorente??
Corresponding author
llorentependas@telefonica.net

Corresponding author.
, Fernando López, Marta Morato, Vanessa Suárez, Andrés Coca, Carlos Suárez
Servicio de Otorrinolaringología, Instituto Universitario de Oncología del Principado de Asturias, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
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Table 1. Clinical Characteristics of Patients.
Abstract
Introduction

Choanal atresia (CA) is an infrequent congenital obliteration of the airway at the level of the posterior nasal aperture resulting in the absence of connection between the nasal cavity and the aerodigestive tract. We present our experience with an endoscopic technique for congenital CA without the use of intranasal stents.

Material and methods

We analysed a series of 10 patients with CA treated in our department from 2006 to 2012 through endoscopic surgery. We present a description of the sample and the surgical technique used.

Results

The sample consisted of 5 men and 5 women. Mean patient age was 8 years (range: 5 days–32 years). Fifty percent of patients were cases with re-stenosis requiring revision surgery. Bilateral presentation was 7 and unilateral was 3. All CA were mixed (bony-membranous). Fifty per cent of patients had an associated malformation. All patients underwent nasal endoscopic surgery without stenting. After a mean follow up of 27 months (range: 11–78 months), the success rate was 100%. No complications were observed.

Conclusion

Transnasal endoscopic repair for both unilateral and bilateral CA without intranasal stenting was found to be a safe, expedient procedure that afforded minimal complications with a high success rate. Endoscopic endonasal surgery may be considered as the mainstay of treatment.

Keywords:
Choanal atresia
Endoscopic nasal surgery
Stents
Resumen
Introducción

La atresia de coanas (AC) es una obliteración congénita y poco frecuente de la vía aérea, resultante de la ausencia de conexión entre la cavidad nasal y el tracto aerodigestivo. Presentamos nuestra experiencia en el manejo de la AC mediante endoscopia nasal sin utilización de stents.

Material y método

Se presenta una serie de 10 casos consecutivos de AC tratados en nuestro servicio mediante cirugía endoscópica entre 2006 y 2012. Exponemos nuestra experiencia y la técnica quirúrgica utilizada.

Resultados

La muestra se componía de 5 varones y 5 mujeres. La edad media de los pacientes era de 8 años (5 días-32 años). El 50% de los pacientes eran casos de reestenosis posquirúrgicas. En 7 casos la AC era bilateral y en 3 unilateral. Todas la AC eran mixtas. El 50% de los pacientes tenía una malformación asociada. Todos los pacientes fueron intervenidos mediante cirugía endoscópica nasal sin colocación de stents. Tras un seguimiento medio de 27 meses (11-78 meses) la tasa de éxito es del 100%. No se observaron complicaciones.

Conclusiones

El tratamiento de la AC mediante endoscopia nasal, tanto unilateral como bilateral, sin implantación de stents es un procedimiento eficaz y seguro. Consideramos que la cirugía endoscópica nasal debería ser considerada actualmente la cirugía estándar en el tratamiento de las AC.

Palabras clave:
Atresia de coanas
Cirugía endoscópica nasal
Stents

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