PDF(Pubmed)
Abstract：
Introduction Choanal atresia (CA) is an uncommon congenital anomaly. There are various syndromes that are associated with CA. The purpose of this study is to determine the differences in CA\'s presentation and outcome when associated with other congenital anomalies and syndromes. Method This is a retrospective review study of all children (18 years and younger) who underwent CA repair in a tertiary referral healthcare center from January 2005 to April 2022. Demographics, comorbidities, radiological testing, operative reports, and outpatient reports were collected. Success was determined as a child with bilateral patent choana that is able to breathe from both nostrils comfortably. Result Twenty-four patients met the criteria for inclusion in this study. Bilateral CA was present in 15 (62.5%) patients. Mixed CA was the most common variant. There were various congenital anomalies in association with CA patients who are yet to be classified into a syndrome. The most common congenital anomaly was cleft lip and palate. Bony and mixed types were significantly associated with non-syndromic patients (p<0.05). Twenty patients (83%) were diagnosed with CA at age of less than one year, and four patients were diagnosed after one year of age. There were 36 surgeries performed on 24 patients, of which 27 were endoscopic and nine were using Hugher dilator. The overall success rate for CA repair was 50%. The median number of revisions per patient was 0.5. Conclusion CA is a challenging anomaly to repair. There are various factors that influence the outcome of children with CA. Otolaryngologists should counsel the patient and their families regarding possible need for revision especially in those with other craniofacial anomalies.
摘要：
介绍Choanal闭锁（CA）是一种罕见的先天性异常。存在与CA相关联的各种综合征。这项研究的目的是确定与其他先天性异常和综合征相关时CA的表现和结果的差异。方法本研究是对2005年1月至2022年4月在三级转诊医疗中心接受CA修复的所有儿童（18岁及以下）的回顾性研究。人口统计,合并症,放射学测试，手术报告,并收集门诊报告。成功被确定为具有双边专利choana的孩子，能够舒适地从两个鼻孔呼吸。结果24例患者符合纳入标准。15例（62.5%）患者存在双侧CA。混合CA是最常见的变体。与CA患者相关的各种先天性异常尚未被分类为综合征。最常见的先天性异常是唇腭裂。骨性和混合型与非综合征患者显著相关(p<0.05)。20名患者（83％）在不到一年的年龄被诊断为CA，四名患者在一岁后被诊断出来。对24名患者进行了36次手术，其中27个是内窥镜检查，9个是使用休尔扩张器。CA修复的总成功率为50%。每位患者的修订中位数为0.5。结论CA是一种具有挑战性的修复异常。影响CA患儿结局的因素有很多。耳鼻喉科医师应就可能需要进行翻修的问题向患者及其家人提供咨询，尤其是那些患有其他颅面异常的患者。
