тел. +38 (044) 483-12-82

№5(6) 2023

Укр

DOI 10.37219/2528-8253-2023-5-85

Zabolotna D, Ismagilov E, Kizim Y

CHOANAL ATRESIA: DIAGNOSIS AND TREATMENT LITERATURE REVIEW AND OWN CLINICAL OBSERVATIONS

Zabolotna Diana D
State Institution “O.S. Kolomiychenko Institute of Otolaryngology of National Academy of Medical Science of Ukraine”; Kyiv, Ukraine.
Head of Department of Rhinology and Allergology with a group of radiology
Doctor of Medical Sciences, Professor
E-mail: dianazab@ukr.net
ORCID ID: https://orcid.org/0000-0001-7807-8148
Scopus Author ID: 57208163951

Ismahilov Eldar
State Institution “O.S. Kolomiychenko Institute of Otolaryngology of National Academy of Medical Science of Ukraine”; Kyiv, Ukraine
Department of Rhinology and Allergology with a group of radiology
Junior researcher
E-mail: ismagilovaldar08@gmail.com
ORCID ID: https://orcid.org/0000-0001-7434-3055

Kizim Yaroslav V.
State Institution “O.S. Kolomiychenko Institute of Otolaryngology of National Academy of Medical Science of Ukraine”; Kyiv, Ukraine
Department of Rhinology and Allergology with a group of radiology
Junior researcher
PhD
E-mail: 90kizim@gmail.com
ORCID ID: https://orcid.org/0000-0001-5062-7707

Abstract

The prevalence, classification, clinical manifestations and methods of treatment of choanal atresia is presented in the paper. Choanal atresia is a relatively rare congenital anomaly characterized by impaired conjugation of the posterior nasal cavity with the nasopharynx. Depending on the degree of nasal obstruction of the newborn, the clinical manifestations of choanal atresia will have a different degree of severity, directly correlates with the timing of the diagnosis. The «gold standard» in the diagnosis of choanal atresia, as well as for other causes of nasal obstruction, is a video endoscopic examination of the nasal cavity. The data of endoscopic examination of the nasal cavity are supplemented by the data of multislice computed tomography of the head. The only treatment for patients with choanal atresia is surgery. Transnasal endoscopic surgical approach is the optimal choice of treatment for patients with choanal atresia. Clinical case is presented in the paper.

Key words: choanal atresia, congenital developmental anomalies, atretic plate.

Download.PDF

References

  1. Alsubaie HM, Almosa WH, Al-Qahtani AS, Margalani O. Choanal Atresia Repair with Stents and Flaps: A Systematic Review Article. Allergy Rhinol. 2021;12:1-13. doi: 10.1177/21526567211058052.
  2. Bajin MD, Önay Ö, Günaydın RÖ, Ünal ÖF, Yücel ÖT, Akyol U, et al. Endonasal choanal atresia repair; evaluating the surgical results of 58 cases. Turkish Journal of Pediatrics. 2021;63:136-40. doi: 10.24953/turkjped.2021.01.016.
  3. Cedin AC, Fujita R, Cruz OL. Endoscopic transeptal surgery for choanal atresia with a stentless folded-over-flap technique. Otolaryngol Head Neck Surg. 2006;135(5):693-698. doi: 10.1016/j.otohns.2006.05.009.
  4. Dedo HH. Transnasal mucosal flap rotation technique for repair of posterior choanal atresia. Otolaryngol Head Neck Surg. 2001;124(6):674-682. doi: 1177/019459980112400615.
  5. Duncan NO, Miller RH, Catlin FI. Choanal atresia and associated anomalies: the CHARGE association. Int J Pediatr Otorhinolaryngol. 1988;15:129-35. doi: 10.1016/0165-5876(88)90063-8.
  6. EL-Ahl MA, El-Anwar MW. Stentless endoscopic transnasal repair of bilateral choanal atresia starting with resection of vomer. Int J Pediatr Otorhinolaryngol 2012;76(7):1002-1006. doi: 10.1016/j.ijporl.2012.03.019.
  7. Emmert C. Stenochorie und Atresie der Choannen, Lehrbach der Speciellen Chirurgie, vol. 2. Stuttgart: Dann; 1854. p. 535-8.
  8. Ferrier S, Hennocq Q, Leboulanger N, Couloigner V, Denoyelle F, Heuzé Y, et al. Nasal cavity shape in unilateral choanal atresia and the role of fetal ventilation in facial growth. J Stomatol Oral Maxillofac Surg. 2021 Apr;122(2):135-140. doi: 10.1016/j.jormas.2020.05.021.
  9. Giannoni C, Sulek M, Friedman EM, Duncan NO 3rd. Acquired nasopharyngeal stenosis: a warning and review. Arch Otolaryngol Head Neck Surg. 1998 Feb;124(2):163-7. doi: 10.1001/archotol.124.2.163.
  10. Hengerer AS, Strome M. Choanal atresia: a new embryologic theory and its influence on surgical management. Laryngoscope. 1982 Aug;92(8 Pt 1): 913-21. https://doi.org/10.1288/00005537-198208000-00012.
  11. Kurosaka H. Choanal atresia and stenosis: Development and diseases of the nasal cavity. Wiley Interdiscip Rev Dev Biol. 2019 Jan;8(1):e336. doi: 10.1002/wdev.336.
  12. Kwong KM. Current updates on choanal atresia. Front Pediatr. 2015;3:1-6. doi: 10.3389/fped.2015.00052.
  13. Moreddu E, Rizzi M, Adil E, Balakrishnan K, Chan K, Cheng A, et al. International Pediatric Otolaryngology Group (IPOG) consensus recommendations: Diagnosis, pre-operative, operative and post-operative pediatric choanal atresia care. Int J Pediatr Otorhinolaryngol. 2019 Aug;123:151-155. doi: 10.1016/j.ijporl.2019.05.010.
  14. Newman JR, Harmon P, Shirley WP, Hill JS, Woolley AL, Wiatrak BJ. Operative management of choanal atresia: a 15-year experience. JAMA Otolaryngol Head Neck Surg. 2013 Jan;139(1):71-5. doi: 10.1001/jamaoto.2013.1111.
  15. Nour YA, Foad H. Swinging door flap technique for endoscopic transeptal repair of bilateral choanal atresia. Eur Arch Otorhinolaryngol. 2008;265 (11):1341-1347. doi: 10.1007/s00405-008-0654-4.
  16. Otto AW. Lehrbuch der Pathologischen Anatomie des Menschen und der Thiere, Vol. 1. Berlin: Recker; 1830. p. 181-3.
  17. Patel VA, Ramadan J, Carr MM. Congenital Choanal Atresia Repair: An Analysis of Adverse Perioperative Events. Otolaryngol Head Neck Surg. 2018 Nov;159(5):920-926. doi: 10.1177/0194599818797282.
  18. Ramsden JD, Campisi P, Forte V. Choanal atresia and choanal stenosis. Otolaryngol Clin North Am. 2009 Apr;42(2):339-52, x. doi: 10.1016/j.otc.2009.01.001.
  19. Stamm AC, Pignatari SSP. Nasal septal cross-over flap technique: a choanal atresia micro-endoscopic surgical repair. Am J Rhinol. 2001 Mar-Apr; 15(2):143-8. doi: 10.2500/105065801781543718.