Abstract
BackgroundTo evaluate the clinical presentation of choanal atresia (CA) in tertiary centers across Canada.MethodsMulti-centre case series involving six tertiary care pediatric hospitals across Canada. Retrospective chart review of patients born between 1980 and 2010 diagnosed with CA at a participating center.ResultsThe health charts of 215 patients (59.6% female) with CA were reviewed and included in this study. The mean age of patients at time of CA presentation was 0.4 months (range 0.1 to 7.2 months) for bilateral CA and 37.8 months (range 0.1 to 164.1 months) for unilateral cases. The most common presenting symptoms for bilateral CA in decreasing order were respiratory distress (96.4%), feeding difficulties (68.2%), and rhinorrhea (65.5%), and for unilateral cases in decreasing order were rhinorrhea (92.0%), feeding difficulties (24.7%), and respiratory distress (18.0%). For the majority of patients (73.2%), the obstruction comprised mixed bony and membranous tissue, with only 10.5% presenting with a purely membranous obstruction. Familial history of CA was confirmed in only 3.3% of cases. One half of patients with CA presented with one or more associated anomalies and 30.6% had a syndrome.ConclusionsThe present investigation is the first national multi-institutional study evaluating the clinical presentation of CA over three decades. The present cohort of CA patients presented with a breadth of co-morbidities with highly variable presentations, with bilateral cases being more severely affected than unilateral cases. Further investigation into hereditary linkages to CA development is warranted.Graphical abstract
Highlights
To evaluate the clinical presentation of choanal atresia (CA) in tertiary centers across Canada
In a two-part investigation, this national study provides a comprehensive review of the clinical presentation (Part I) and management (Part II) of a large sample of patients with CA treated at tertiary care centres across Canada
The present paper reports on the clinical presentation of CA
Summary
To evaluate the clinical presentation of choanal atresia (CA) in tertiary centers across Canada. Choanal atresia (CA) is a congenital condition resulting in obstruction of the posterior nasal passage(s), known as the choana, that may be bony, membranous or mixed bony-membranous. The incidence of this uncommon entity is approximately one in 5000 to 8000 live births [1, 2]. Ongoing controversy regarding best practices for clinical management of CA lies, in part, in the rarity of the disorder and the limited level of evidence available in published studies on this subject matter. In a two-part investigation, this national study provides a comprehensive review of the clinical presentation (Part I) and management (Part II) of a large sample of patients with CA treated at tertiary care centres across Canada. The following outcomes were explored: presentation and diagnosis of CA, and family history
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