Endoscopic trans-nasal choanotomy: a case series

Abstract

Background:Choanal atresia is a rare congenital failure of communication of the nasal cavity and the nasopharynx. The technique for the surgical repair of choanal atresia has evolved from the blind transnasal puncture to the currently favored endoscopic transnasal approach. This study aims at assessing the technique of endoscopic transnasal choanotomy; and highlight if any its benefits in our practice. This is an on-going study of all consecutive patients with choanal atresia, who had endoscopic transnasal choanotomy at the Otorhinolaryngology department of Aminu Kano Teaching Hospital from January to October, 2014. Four patients were recruited into the study and they all had endoscopic transnasal choanotomy with stenting of the neo- choanae. There were 3 females and 1male and their ages ranged between 12days and 18years. They all presented with varying degrees of persistent nasal obstruction, rhinorrhea and respiratory distress. Diagnostic nasal endoscopy and CT scan confirmed 1 patient had a bilateral membranous type atresia, 1 had bilateral bony atresia and 2 had right sided mixed membranous/bony atresia. Post-operative complications included rhinosinusitis, stent extrusion and granulation tissue formation. Follow ups at various intervals revealed 3 patients had adequate neo-choanal patency and 1 had a restenosis and was re-operated. This study found endoscopic choanotomy safe and effective in the treatment of choanal atresia in our practice.