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Abstract：
BACKGROUND: Choanal atresia is a rare congenital malformation of the nasal cavity characterized by the complete obliteration of the posterior choanae. In 67% of cases choanal atresia is unilateral, affecting mainly (71%) the right nasal cavity. In contrast to the unilateral form, bilateral choanal atresia is a life-threatening condition often associated with respiratory distress with feeding and intermittent cyanosis exacerbated by crying. Surgical treatment remains the only therapeutic option.
OBJECTIVE: To report our experience in the use of a transnasal endoscopic approach with stentless single side-hinged flap technique for the surgical management of choanal atresia.
METHODS: A 5 year retrospective analysis of surgical outcomes of 18 patients treated for choanal atresia with a transnasal technique employing a single side-hinged flap without stent placement. All subjects were assessed preoperatively with a nasal endoscopy and a Maxillofacial computed tomography scan.
RESULTS: Ten males and eight females with a mean age at the time of surgery of 20.05±11.32 years, underwent surgery for choanal atresia. Fifteen subjects (83.33%) had a bony while 3 (26.77%) a mixed bony-membranous atretic plate. Two and sixteen cases suffered from bilateral and unilateral choanal atresia respectively. No intra- and/or early postoperative complications were observed. Between 2 and 3 months after surgery two cases (11.11%) of partial restenosis were found. Only one of these presented a relapse of the nasal obstruction and was subsequently successfully repaired with a second endoscopic procedure.
CONCLUSIONS: The surgical technique described follows the basic requirements of corrective surgery and allows good visualization, evaluation and treatment of the atretic plate and the posterior third of the septum, in order to create the new choanal opening. We believe that the use of a stent is not necessary, as recommended in case of other surgical techniques involving the use of more mucosal flaps.
OBJECTIVE: To report our experience in the use of a transnasal endoscopic approach with stentless single side-hinged flap technique for the surgical management of choanal atresia.
METHODS: A 5 year retrospective analysis of surgical outcomes of 18 patients treated for choanal atresia with a transnasal technique employing a single side-hinged flap without stent placement. All subjects were assessed preoperatively with a nasal endoscopy and a Maxillofacial computed tomography scan.
RESULTS: Ten males and eight females with a mean age at the time of surgery of 20.05±11.32 years, underwent surgery for choanal atresia. Fifteen subjects (83.33%) had a bony while 3 (26.77%) a mixed bony-membranous atretic plate. Two and sixteen cases suffered from bilateral and unilateral choanal atresia respectively. No intra- and/or early postoperative complications were observed. Between 2 and 3 months after surgery two cases (11.11%) of partial restenosis were found. Only one of these presented a relapse of the nasal obstruction and was subsequently successfully repaired with a second endoscopic procedure.
CONCLUSIONS: The surgical technique described follows the basic requirements of corrective surgery and allows good visualization, evaluation and treatment of the atretic plate and the posterior third of the septum, in order to create the new choanal opening. We believe that the use of a stent is not necessary, as recommended in case of other surgical techniques involving the use of more mucosal flaps.
摘要：
背景：Choanal闭锁是一种罕见的先天性鼻腔畸形，其特征是后部choanae完全闭塞。在67％的病例中，后鼻孔闭锁是单方面的，主要影响（71%）右鼻腔。与单边形式相反，双侧后鼻孔闭锁是一种危及生命的疾病，通常与进食引起的呼吸窘迫和哭闹加剧的间歇性紫癜相关。手术治疗仍然是唯一的治疗选择。
目的：报告我们使用经鼻内镜入路无支架单侧铰链皮瓣技术治疗后鼻孔闭锁的经验。
方法：对18例后鼻孔闭锁患者的手术结果进行了5年的回顾性分析，这些患者采用了单侧铰链式皮瓣而没有支架放置的经鼻技术。所有受试者均在术前通过鼻内窥镜检查和颌面计算机断层扫描进行评估。
结果：10名男性和8名女性，手术时的平均年龄为20.05±11.32岁，接受了后鼻孔闭锁的手术。15名受试者（83.33％）患有骨性，而3名受试者（26.77％）患有混合的骨膜阁楼板。分别有2例和16例患有双侧和单侧后鼻孔闭锁。未观察到术中和/或术后早期并发症。术后2～3个月发现部分再狭窄2例（11.11%）。其中只有一个出现鼻塞复发，随后通过第二次内窥镜手术成功修复。
结论：所描述的手术技术遵循矫正手术的基本要求，并允许良好的可视化，评估和治疗闭锁钢板和隔膜的后三分之一，为了创造新的后鼻孔开口。我们认为没有必要使用支架，在其他涉及使用更多粘膜皮瓣的手术技术的情况下，这是推荐的。
目的：报告我们使用经鼻内镜入路无支架单侧铰链皮瓣技术治疗后鼻孔闭锁的经验。
方法：对18例后鼻孔闭锁患者的手术结果进行了5年的回顾性分析，这些患者采用了单侧铰链式皮瓣而没有支架放置的经鼻技术。所有受试者均在术前通过鼻内窥镜检查和颌面计算机断层扫描进行评估。
结果：10名男性和8名女性，手术时的平均年龄为20.05±11.32岁，接受了后鼻孔闭锁的手术。15名受试者（83.33％）患有骨性，而3名受试者（26.77％）患有混合的骨膜阁楼板。分别有2例和16例患有双侧和单侧后鼻孔闭锁。未观察到术中和/或术后早期并发症。术后2～3个月发现部分再狭窄2例（11.11%）。其中只有一个出现鼻塞复发，随后通过第二次内窥镜手术成功修复。
结论：所描述的手术技术遵循矫正手术的基本要求，并允许良好的可视化，评估和治疗闭锁钢板和隔膜的后三分之一，为了创造新的后鼻孔开口。我们认为没有必要使用支架，在其他涉及使用更多粘膜皮瓣的手术技术的情况下，这是推荐的。
