Endoscopic management of infantile non atretic nasal obstruction

Abstract

Objective of the study: Evaluate some of the non atretic indications for endoscopic infantile nasal surgery regarding surgical technique, safety, and success.Patients and Methods: Retrospective analysis of 14 infants required endoscopic nasal surgery for severe non atretic nasal blockage in ORL department mansoura university hospital between 2010 and 2017, their age ranged between 1 month and 19 months, 8 female and 6 males. The indications were nasal obstruction due to craniofacial anomaly (Cruozon syndrome) 3 cases, post traumatic nasal adhesions 10 cases, and congenital pyriform aperture stenosis in 1 case. Endoscopic nasal surgery was conducted to perform widening of the nasal airway through bilateral partial inferior turbinectomy in Cruozon syndrome, nasal adhesolysis with or without stenting in post traumatic nasal adhesions, or trans nasal correction of pyriform aperture stenosis.Results: All patients showed postoperative improvement without restenosis or complications during follow up period in all study groups, only one patient of nasal adhesions group showed restenosis and didn’t complete the follow up.Conclusion: TVarious non atretic indications for infantile endoscopic surgery as nasal adhesions, nasal obstruction in crouzon syndrome and CPAS could properly managed with endoscopic surgery. Careful management of nasal obstruction during neonatal care with delicate handling is very important to avoid unnecessary complications as nasal adhesions. Proper knowledge and experience with endoscopic surgery in this age is mandatory regarding the preoperative preparation and planning, operative technique, and post operative follow up. The technique is challenging and required good experience yet it is rewarding and mostly successful.