ABSTRACT
During a period of 19 years we have treated 65 infants with choanal atresia. Thirty of them showed a bilateral atresia, thirty-five a unilateral (29 left-sided, 6 right-sided). Fifty patients were girls, fifteen boys. In 27 cases the abnormality was combined with other anomalies. Most infants have been operated upon in the first six months of their life by a transpalatinal approach in general anethesia. From the results the following conclusions can be made: early treatment is the method of choice; restoration of nasal permeability, although minimal, allows normal nutrition and diminishes a number of respiratory infections, due to choking. The transpalatinal approach permits a direct control of the surgical area. It does not inhibit the growth of the hard palate and the function of the soft palate. Failures are caused by difficulties to keep the new passage open.
Subject(s)
Nasal Cavity/abnormalities , Nasopharynx/abnormalities , Abnormalities, Multiple , Child , Female , Follow-Up Studies , Humans , Infant , Infant, Newborn , Male , Methods , Nasal Cavity/surgery , Nasopharynx/surgeryABSTRACT
Many clinical observations point to a primary viral cause in exudative otitis media. This seromucinous inflammation may then develop into a purulent inflammatory phase as a result of subsequent bacterial infection. The aetiology of otitis media may thus be viral, viral bacterial or bacterial. Viruses and bacteria multiply in a different manner within the organism. They also give rise to different defence reactions and physical signs of their different pathogenic effects. Viral otitis is characterised by proliferative tissue changes, such as telangiectatic granulations, adhesions, cholesteatomas and limitation of pneumatisation of the mastoids. Destructive tissue damage is predominant in bacterial infections, e.g., tympanic perforations and bone destruction. 100 children were examined virologically during acute exudative otitis media and in the presence of a cholesteatoma. Viral aetiology was proved in many cases and viral antigens were demonstrated in the cholesteatomatous material.
