TRANSNASAL ENDOSCOPIC REPAIR OF CONGENITAL CHOANAL ATRESIA - LONG-TERM RESULTS

Objective: To evaluate the short-and long-term success of the repair o f congenital choanal atresia using the transnasal endoscopic approach with and without power instruments. Design and Setting: Retrospective case series in a tertiary care center. Patients: Fifteen patients with either unilateral or bilateral congenital choanal atresia were treate d using the transnasal endoscopic approach. Postoperative stenting was used in all 15 patients. Interventions: The senior surgeon (C.W.G.) c urrently uses the transnasal endoscopic drill-out technique. We descri be our experience and long-term follow-up of 15 patients (9 with unila teral atresia, 5 with bilateral atresia, and I with unilateral stenosi s) who were treated with the use of the transnasal endoscopic techniqu e during a 7-year period. In 8 patients, the transnasal endoscopic tec hnique was performed using conventional biting instruments, and in 7 p atients, the transnasal endoscopic technique with power instruments wa s used. Main Outcome Measure: The patency of the surgical repair of co ngenital choanal atresia by the transnasal endoscopic approach. Result s: Of 14 patient procedures, 12 remained patent. One patient required minor debridement of granulation tissue 1 week following stent removal , and I patient required surgical transnasal revision 2 months after t he primary procedure, with a patent result after the second procedure. Despite patent choanae being achieved, 1 patient died of cardiac anom alies 8 months after the atresia repair. Conclusions: The transnasal e ndoscopic route offers excellent visualization of the posterior choana and, hence, the ability to open the defect widely with a high surgica l success rate. Newer powered instrumentation further enhances the abi lity to perform this technique cleanly.