Choanal atresia: Diagnosis and management

Objective: Choanal atresia (CA) is a rare congenital malformation caused by the obliteration of the posterior choanae by an atretic plate. The aim of our study is to describe the diagnosis and management modalities of CA and to determine the factors associated with recurrence. Materials and methods: This is a retrospective study based on the medical records of patients with CA managed in our department in the period between 2002 and 2021. We studied the clinical features and management modalities of each patient. For patients who developed a recurrence, we determined the factors associated with recurrence based on a bivariate analysis. Results: We studied the medical records of 26 patients with either a bilateral (n=8) or a unilateral (n=16) form of CA. The median age at surgery was two days for bilateral forms and 5 years and 4 months for unilateral forms. At computed tomography scan, CA was mixed (n=20), bony (n=4) or membranous (n=2). All patients underwent intranasal endoscopic surgical treatment using cold instruments alone in membranous forms and combined to the drilling of the atretic plate in bony and mixed forms. The surgical management included the resection of the posterior part of the vomer bone and the placement of nasal stents in 10 and 16 patients respectively. We recorded 6 cases of recurrence requiring a surgical re-intervention. The presence of associated cranio-facial malformations was the only factor associated with recurrence (p=0,001). Conclusion: Choanal atresia diagnosis was based on nasal endoscopy and CT scan. Surgical treatment using transnasal endoscopic approach was an effective and safe technique. Associated local malformations was a factor associated with re-stenosis

Atresie choanale: une malformation a ne pas meconnaitre: etude de 3 cas au Centre Hospitalier Universitaire de Lome (Togo)

L'atresie choanale est une malformation congenitale rare. Son diagnostic clinique facile doit etre realise des la naissance par la sage-femme ou l'obstetricien. Pour cela; nous conseillons l'examen du nouveau-ne avec aspiration naso-pharyngee systematique dans toutes les maternites. Cette attitude evitera la meconnaissance de l'atresie choanale unilaterale. Le traitement repose sur la divulsion avec calibrage de la choane atresiee. Les auteurs rapportent 3 cas diagnostiques en ORL dans les delais de 7 jours a 8 mois et traites avec succes par la divulsion