Posterior septectomy in transnasal endoscopic choanoplasty

Congenital choanal atresia [CA] is a challenging surgical problem. Choosing between the transnasal and transpalatal routes is still a controversial feature in the surgical management of CA. The purpose of this study was to evaluate the results of transnasal endoscopic choanoplasty with versus without posterior septectomy. Thirteen patients were included in this study [8 females and 5 males] aged 3 days to 17 years [mean age 4.06 years], 7 cases with bilateral CA and 6 cases with unilateral CA who underwent surgical repair at Al-Azhar university hospitals between 2004 and 2008. All patients underwent transnasal endoscopic repair using powered instrument. The first 5 cases had repair without posterior septectomy, while the last 8 cases had repair with posterior septectomy. All cases were stented for 4 to 6 weeks and followed for at least 10 months. Postoperatively, 11 patients [84.6%] had successful repair, while 2 cases [15.4%] had restenosis which needed revision surgery. Restenosis occurred in 2 of the 5 cases who underwent repair without posterior septectomy. No restenosis in patients who underwent repair with posterior septectomy. One patient developed pressure necrosis of the palate few days after surgery, which healed after replacement of the stent by a smaller one

Endoscopic appearance of the nasal opening of human nasopalatine duct

The nasopalatine duct [NPD] in human adults is rarely patent and likely exists as a vestigial remnant. NPD is a common site for infection, tumors and cysts. This study was done to describe the location and gross anatomy of the nasal opening of the human NPD. A total of 100 volunteers, at Al-Azhar university hospitals, were examined by 30° telescope for the site and appearance of the nasal opening of NPD and photographs were taken and examined. Our results showed that the NPD was located 3 mm +/- 0.2 mm [mean +/- SD] above the nasal floor on the nasal septum, in both nostrils [90% bilateral], 2 cm +/- 0.03 cm dorsal to the columella. NPD was detected in 95% of the examined nostrils. The shape of the NPD fossa was oval [70%], and round [30%]. In the center of the fossa, a small, round aperture was visualized in 33% of fossae. In conclusion, the nasal opening of the NPD is an easily detectable bilateral and symmetrical structure, located at the junction of the nasal septum and floor of the nasal cavity. It can be potentially useful as an anatomical landmark