Causes of restenosis in the surgical treatment of congenital choanal atresia in children

Abstract

To find the causes of restenosis after a choanotomy in children with CAC. We analyzed the results of surgical treatment of 144 children with the use of an endoscopic transnasal technique (n=94) and without using endoscopy (n=67). In patients with signs of restenosis, endoscopic revision of the choanal opening, computed tomography results clarifying the anatomy of the abnormal zone, anamnestic data, and the presence of concomitant pathology were assessed. The primary causes of the recurrence of the CAC are the concomitant anatomical features of the structure of the choanal zone, insufficient period of protector insertion in the postoperative period, and surgical intervention without visual control. Endoscopic transnasal choanotomy with intraoperative rhino- and epipharingoscopic imaging, which is performed taking the individual characteristics of the anatomy of the anomalous zone into account, is the most optimal surgical procedure in pediatric patients. In combination with the use of a protector with a distal extended zone, high efficiency and rarity of restenosis are achieved.