Symptome und Therapie der Choanalatresie--Stents weiterhin umstritten

TY - JOUR

T1 - Symptome und Therapie der Choanalatresie--Stents weiterhin umstritten

AU - Havel, M

AU - Nicolai, T

AU - Betz, C S

AU - Berghaus, A

AU - Leunig, A

N1 - © Georg Thieme Verlag KG Stuttgart · New York.

PY - 2010/12

Y1 - 2010/12

N2 - Congenital choanal atresia is a rare malformation of the upper airways occurring sole or within the scope of syndromes. The controversy regarding standardized surgical approach and optimal technique preventing re-stenosis as well as the proceeding in case of a unilateral malformation persists. To address these issues, a retrospective analysis of patients presenting with choanal atresia in our department within the last 10 years was performed. 15 infants aged 3 days to 13 years (mean 42 months) who presented with unilateral (10 cases) and bilateral (5 cases) choanal atresia underwent surgical repair. 4 patients failed previous surgeries. All interventions were performed in transnasal endoscopic technique. 7 patients were intraoperatively stented for 6 weeks, 4 patients for 1 week. In 73% (11 out of 15 children) further congenital anomalies were identified. In 7 cases a re-stenosis requiring treatment occurred, predominantly in long-term stented patients. No intra- or postoperative hemorrhages or infections occurred. To provide an adequate work-up of affected patient including a screening for further congenital anomalies, a multidisciplinary approach is required. Endonasal endoscopic approach represents a safe technique for surgical repair of choanal atresia. The indication for surgical repair in case of a unilateral atresia is based on the severity of clinical symptoms. The use of stents, especially of long term, remains controversial and needs further evaluation.

AB - Congenital choanal atresia is a rare malformation of the upper airways occurring sole or within the scope of syndromes. The controversy regarding standardized surgical approach and optimal technique preventing re-stenosis as well as the proceeding in case of a unilateral malformation persists. To address these issues, a retrospective analysis of patients presenting with choanal atresia in our department within the last 10 years was performed. 15 infants aged 3 days to 13 years (mean 42 months) who presented with unilateral (10 cases) and bilateral (5 cases) choanal atresia underwent surgical repair. 4 patients failed previous surgeries. All interventions were performed in transnasal endoscopic technique. 7 patients were intraoperatively stented for 6 weeks, 4 patients for 1 week. In 73% (11 out of 15 children) further congenital anomalies were identified. In 7 cases a re-stenosis requiring treatment occurred, predominantly in long-term stented patients. No intra- or postoperative hemorrhages or infections occurred. To provide an adequate work-up of affected patient including a screening for further congenital anomalies, a multidisciplinary approach is required. Endonasal endoscopic approach represents a safe technique for surgical repair of choanal atresia. The indication for surgical repair in case of a unilateral atresia is based on the severity of clinical symptoms. The use of stents, especially of long term, remains controversial and needs further evaluation.

KW - Adolescent

KW - CHARGE Syndrome

KW - Child

KW - Child, Preschool

KW - Choanal Atresia

KW - Cooperative Behavior

KW - Craniofacial Abnormalities

KW - Endoscopy

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Infant

KW - Infant, Newborn

KW - Interdisciplinary Communication

KW - Magnetic Resonance Imaging

KW - Male

KW - Patient Care Team

KW - Postoperative Care

KW - Postoperative Complications

KW - Stents

KW - Surgery, Computer-Assisted

KW - Tomography, X-Ray Computed

KW - English Abstract

KW - Journal Article

U2 - 10.1055/s-0030-1262781

DO - 10.1055/s-0030-1262781

M3 - SCORING: Zeitschriftenaufsatz

C2 - 20862629

VL - 222

SP - 430

EP - 436

JO - KLIN PADIATR

JF - KLIN PADIATR

SN - 0300-8630

IS - 7

ER -