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At least 19 recordsLinked to original sources
PubMed1991

Esophageal atresia, choanal atresia, and dysautonomia.

Patients with esophageal atresia (EA) or choanal atresia (CA) manifest similar clinical and pathophysiological features. To determine the significance of this observation, the clinical records of 80 patients with EA and 57 with CA were reviewed. This survey showed that similarities between the two conditions included inspiratory and expiratory dyspnea, episodes of reflex apnea and/or bradycardia, oropharyngeal dysphagia, vomiting, convulsions, hyperhydrosis, hyperthermia, sialorrhea, and sudden death. After the second year of life most symptoms disappeared spontaneously. In both conditions, respiratory effort resulted in partial or complete obstruction affecting both the inspiratory and expiratory phases of the respiratory cycle. Support for this finding was obtained by studying the breathing pattern of 3 patients with EA and 3 with CA, before and during postural respiratory loading. The data suggest that patients with EA are similar to those with CA, having upper airway instability that may result in obstructive hypopnea or apnea associated with expiratory grunting. It is possible that this upper airway instability is a manifestation of more general maturational dysautonomia previously not recognised in patients with EA.

Apnea↗
PubMed2004

Rectal atresia, choanal atresia and congenital heart disease: a rare association.

Rectal atresia is an extremely rare anorectal malformation. A unique case of rectal atresia presenting as an imperforate membrane associated with congenital cardiac malformations and unilateral choanal atresia in a newborn is reported. Ultrasound examination in the newborn infant located the presence of the rectal membrane which was surgically treated successfully.

Choanal Atresia↗
PubMed1998

[The treatment of choanal atresia].

Choanal atresia occurs in approximately 1 out of every 8000 live births. In about 60% of these cases it is unilateral and is often associated with other major craniofacial anomalies or visceral malformations such as the so-called CHARGE syndrome (i.e. Choloboma, Heart defects, choanal Atresia, Retarded growth and development, Genital anomaly, and Ear defect with deafness) first described by Pagon in 1981. In newborns the clinical manifestations of choanal atresia consist of respiratory distress strictly related to the entity of nasal obstruction. Total bilateral congenial choanal atresia must, therefore, be considered a surgical emergency since nasal obstruction impedes the suction mechanism and hence normal feeding in the newborn. For this reason, prompt surgery is mandatory. The surgical approach employed in choanal atresia consists of both the trans-nasal and trans-palatal approaches. Between 1985 and 1997 31 patients with choanal atresia were treated in our department (16 males, 15 females; age range 2 days-5.5 years; mean 11.4 months). In 25 cases (80.6%) the malformation was bilateral. Associated anomalies were seen in 8 patients (25.8% of cases). All of these patients were treated using the trans-nasal approach, under general anesthesia, and endoscopic control. In 27 cases a trocar was employed to perforate the bony atresia and a stent was then positioned. Three patients underwent contact-laser resection of the stenosis without requiring any further stent and without any complications. None of these patients developed total recurrences, although after varying amounts of time, in 8 of the 27 patients operated using the trocar (29.6% of cases) a partial reduction of the airway occurred, the substenosis requiring dilatation with progressive Hegar dilators. In the remaining cases contact-laser therapy was associated with dilation. Three of the patients were treated by laser-therapy alone and none developed a recurrence. One patient dropped out of the follow-up for other serious malformations.

Child, Preschool↗
PubMed1989

Diagnosis and treatment of congenital choanal atresia.

Choanal atresia is the developmental failure of the posterior nasal cavity to communicate with the nasopharynx. Because of its rare incidence, otolaryngologists have limited experience in treating this unusual congenital anomaly. We report the case of a seventeen year old female with bilateral membrano-osseous choanal atresia who miraculously survived her anomaly and was not definitively diagnosed and surgically treated until she was seventeen. Definitive surgical correction of choanal atresia is challenging. The various methods advocated include the transnasal, transpalatal, trans-septal and sublabial approaches. We will discuss the various treatment options and relate our own personal experience in the management of choanal atresia. A review of the literature on the various modalities available for surgery, stenting and rehabilitation will be discussed also.

Adolescent↗
PubMed2005

Use of the automatic tympanometer as a screening tool for congenital choanal atresia.

Choanal atresia is a significant congenital anomaly, which may be associated with other congenital anomalies. Recommendations have been previously proposed for neonatal screening of all newborns to detect this condition. A previously unreported, simple method using the automatic tympanometer to screen newborns for congenital choanal atresia is proposed. A prospective study was performed over a one-month period on all newborns at El-Sahel Teaching Hospital, Cairo, to evaluate the efficacy of this manoeuvre. The nostrils of 143 newborn infants were evaluated during the study period. The sensitivity of the technique in diagnosing a patent nostril was 100 per cent. The specificity of the technique for detecting distal obstruction was 100 per cent. There were no complications of the described procedures. The study revealed that the novel method of screening for choanal atresia in newborns using the automatic tympanometer is simple, minimally invasive and highly reproducible.

Acoustic Impedance Tests↗
PubMed2003

Technique for fabrication of splint preventing postsurgical restenosis in choanal atresia.

Choanal atresia, a congenital narrowing or obstruction of the nasal airway caused by significant respiratory distress in neonates, may require emergency intervention. Although atresia can be repaired surgically, restenosis is a common complication with this procedure. To prevent this, tubes are inserted into the nasal cavity immediately after surgery. This article describes a technique for preparing individual surgical splints designed to prevent postsurgical obstruction of the nasal cavity.

Choanal Atresia↗
PubMed1988

[Computerized tomography imaging of choanal atresia].

Choanal atresia is a rare malformation of the nose. If it occurs bilaterally, it may cause life-threatening complications shortly after birth. The disease is mainly diagnosed clinically. Only few cases have been presented and documented by means of radiologic procedures. In particular, CT presentation of this malformation has to our knowledge not been published to date.

Choanal Atresia↗
PubMed1990

A simple transnasal procedure for treating choanal atresia.

Bilateral choanal atresia is a rare but life-threatening disorder. Prompt diagnosis and emergency treatment are necessary. Various transnasal tools as well as other techniques have been tried in the past: they have all been associated with complications. The authors report a treatment of a newborn with a simple and previously unreported procedure for dealing with bilateral choanal atresia. As described, the use of a simple hand-powered drill and bit offers an approach which is straightforward and free of complications. Efficacy of this procedure is documented by a 6-year follow-up period.

Choanal Atresia↗
PubMed1982

Transseptal repair of unilateral choanal atresia.

Unilateral choanal atresia is a congenital problem initially observed by the otolaryngologist as unilateral nasal obstruction. Elective surgical correction can be done using the transnasal, transpalatal, transantral, or transseptal techniques. Two patients underwent this procedure with the transseptal technique. We believe this is a safe, uncomplicated, and reliable technique for the correction of unilateral choanal atresia.

Child↗
PubMed1997

Advanced drill technology in treatment of congenital choanal atresia.

Congenital choanal atresia is a challenging clinical problem requiring prompt diagnosis and intervention. The method of repair is controversial, with no technique having gained universal acceptance. Proponents of the transnasal repair must acknowledge the variability of results, especially with thick bony plates, and the technical difficulties associated with this method. Advocates of the transpalatal route must recognize the associated morbidity of this technique in the newborn. The adaptation of the endoscopic technique and the development of new powered instrumentation have significantly improved the transnasal technique so that safe controlled repair may now be accomplished in the newborn.

Choanal Atresia↗
PubMedDate not supplied

The anatomy of congenital choanal atresia.

Congenital choanal atresia is rare. Previous literature has dealt with the diagnosis and management of these patients, but there are no reports that accurately describe the nature of the deformity. This is a presentation of two patients with tomographic demonstration of the abnormality which confirms the surgical descriptions of previous authors. These abnormalities are (1) narrowing of the entire nasal chamber, (2) primary bony obstruction with an area of membranous obstruction, and (3) gross deformity of the vomer.

Child↗
PubMed1981

Congenital choanal atresia.

Bilateral choanal atresia is a medical emergency. With good nursing care and close observation, surgery may be delayed until it is deemed safe and there is a good chance of success. Surgical treatment of unilateral atresia is better delayed to optimize the conditions for successful surgery. There are three surgical approaches for the correction of this anomaly: transnasal, transpalatal, and trans-septal. Each has advantages and disadvantages. The patient's age is an important consideration in the choice of the technique. Partial vomer removal minimizes the likelihood of restenosis. It is widely accepted that the transnasal microsurgical technique has improved the safety and success rate in infants and younger children. The transpalatal or trans-septal approach is preferred in older children and adults.

Airway Obstruction↗
PubMedDate not supplied

Hospital and home care of the infant with congenital bilateral choanal atresia.

Congenital bilateral choanal atresia in the newborn presents a nursing challenge in both the hospital and the home setting. Emergency intervention is necessary at birth to ensure the infant's survival. Surgery within the first month is frequently necessary to perforate the blocked nasal passages. After these interventions, the infant requires continued care within the home. This article reviews the hospital and home care of the infant with bilateral choanal atresia, stressing the need for health professionals to support family members in caring for the infant.

Breast Feeding↗
PubMed1990

The endoscopic repair of choanal atresia.

Since 1755, when choanal atresia was first described by Roederer, more than 300 papers have appeared in the literature dealing with various aspects of choanal atresia. Today's preferred methods of repair are transnasal and transpalatal. Each method has its advantages, disadvantages, proponents, and opponents. The main disadvantage of the transnasal procedure is limited vision, even with a microscope, especially in newborn infants, and the inability to adequately remove enough vomerine septal bone to prevent restenosis. Endoscopic transnasal repair of choanal atresia provides excellent visualization and the ability to perform exact surgery on patients of all ages. Described are four patients who underwent endoscopic repair of choanal atresia. Three of the four have patent nares, one patient after revision surgery. The technique is discussed along with its advantages and disadvantages relative to other surgical treatment modalities.

Child, Preschool↗
PubMed1994

Unilateral choanal atresia masquerading as chronic sinusitis.

Choanal atresia is a congenital anomaly usually diagnosed at birth. This case involves bilateral choanal atresia in a newborn with respiratory difficulties in whom there is an inability to pass a #8 French catheter through the nose. In contrast, unilateral choanal atresia causes a variable degree of nasal obstruction that may delay the diagnosis. We report a case of unilateral choanal atresia in a 9-year-old boy diagnosed as having chronic sinusitis with allergic rhinitus. Initial interpretation of a computerized, tomographic (CT) examination confirmed the diagnosis of chronic sinusitis. The definitive diagnosis, however, was made by endoscopic evaluation. A review is presented of the epidemiology, clinical presentation, differential diagnosis, and contemporary surgical management for unilateral choanal atresia.

Child↗
PubMed1987

Sublabial transseptal repair of choanal atresia or stenosis.

Bilateral choanal atresia in newborns and infants carries significant morbidity and mortality, therefore, prompt correction is required. The transnasal route is usually preferred in the infant age group. This approach, however, carries significant incidence of restenosis. The transpalatal correction of choanal atresia has been the definitive approach in older children and adults. We are introducing a new procedure for correction of choanal atresia or stenosis that can be used at any age. The sublabial transseptal repair was performed in four infants without complications or restenosis. Two of our patients previously underwent different types of repair with persistent choanal stenosis. The sublabial transseptal approach provides wide exposure to the nasal cavity and the floor leading to the choanae. The operating microscope and various otologic micro-instruments were used in the surgical dissection. Preservation of the anterior inferior cartilaginous septum and the maxillary crest and spine is mandatory in order not to disturb the nasal growth pattern of the nose and premaxilla. The infants were evaluated with a computed tomography (CT) scan, preoperatively. The posterior inferior portion of the vomer is uniformly wide, increasing the degree of stenosis or atresia. Removal of the vomer is an essential part of this procedure in order to open and enlarge the choanae. Both choanae were stented with polyvinyl tubes. Every attempt was made to keep the stents in position for a minimum of 8 to 10 weeks. Follow-up has been for 2 to 4 years, and no recurrent choanal stenosis has been experienced.

Choanal Atresia↗
PubMed1995

Transnasal repair of choanal atresia using telescopes.

OBJECTIVE: Choanal atresia, consisting of a unilateral or bilateral bony or membranous septum between the nose and the pharynx, occurs in approximately one of 7000 live births. Conventional treatment has consisted of watchful observation and elective surgical repair or immediate intervention using a variety of surgical techniques. We attempted transnasal repair using a telescope to remedy the obstruction. PATIENTS: Over an 18-month period, six female and four male patients, who were between 3 weeks and 14 years of age at the time of surgery, underwent transnasal repair of unilateral or bilateral choanal atresia with the aid of a rod-lens telescope. All 10 patients had nasal stents made from endotracheal tubes that were fixed with sublabial and transseptal sutures. RESULTS: Seven patients remain free of symptoms 18 to 24 months after surgery. Three patients required revision surgery. Two of the revision cases recovered completely, with no restenosis 12 months after the second surgery. There were no postoperative complications. CONCLUSION: Transnasal repair of choanal atresia using a rod-lens telescope appears to be an effective procedure with low morbidity.

Adolescent↗
PubMedDate not supplied

Congenital choanal atresia in siblings.

Choanal atresia is a relatively rare anomaly of the upper airway, which can result in significant respiratory distress in the newborn. It is often associated with other anomalies and has only rarely been reported in siblings. We report its isolated occurrence in two siblings.

Choanal Atresia↗