Choanal Atresia: Surgery by Puncture, Dilation and Stenting

ABSTRACT

BACKGROUND AND OBJECTIVES: The bilateral choanal atresia is a medical emergency for which surgery is the only and definite treatment. We performed an atretic bone perforation using Hagers dilators. The purpose of this study, then, is to evaluate the efficacy of this simple technique of perforation, dilation and stenting. MATERIAL AND METHODS: We studied five patients who underwent surgery for a complete bilateral bony atresia from 1994 to 2004. All the patients were newborn two males and three females babies. The male female ratio was 1 1.5. Their age varied from 1 day to 4 days. The surgery was performed with Hagers dilators using the puncture and dilation technique. Stenting was carried out in all cases using a non cuffed endotracheal tube. RESULTS: The reestablishment of the nasal passage through a perforating atretic plate was considered a successful criteria of surgery. All the neonates had good nasal air passage after the perforation, dilation and stenting. Two of the patients who were with the CHARGE association died within 7 days due to causes unrelated to surgery. The other three patients had successful removal of stent after six weeks. There was no follow-up afterwards. CONCLUSION: The puncture, dilation and stenting technique by Hagers dilator is safe, quick and simple. It involves minimum blood loss and is without any complications. Stenting, therefore, is essential for preventing restenosis.