Foley's catheter dilatation in the management of choanal atresia; A prospective non-randomized case-series

Abstract

Background: Choanal atresia treatment is by operative opening of the choana using a transnasal or transpalatal approaches. The main goals of the surgery are creating a satisfactory opening and guarding against restenosis. Many surgeons use stents aiming to prevent or minimize restenosis. Searching for a feasible method decreasing the incidence of restenosis and abolishing the need for stents; we thought of Foley's catheters' dilatation during and after the surgical correction of the atresia. Patients and Methods: A non - randomized prospective single-blinded case series study. After finishing the bony and soft tissue work, we applied Foley's catheter (size 12 Fr) in the new opening, inflated with normal saline to its maximum capacity for 3 minutes, deflated for one minute then re-inflated for another 3 minutes. No packs or stents were placed. In the follow up visits and under endoscopic vision, the surgical opening was routinely dilated with 12 or 14 FR Foley's catheters. Results: Fourteen infants were included with age ranging from 3 to 11 days (mean 6.14). Twelve cases (85.7%) showed criteria of success at the end of the follow up period. Two cases (14.3%) needed revision surgery at ages of 4 and 6 months. They had considerable granulations that were refractory to balloon dilatation and conservative treatment and led to considerable stenosis. Conclusion: Using Foley's catheters is a feasible, effective, safe and cheap alternative for dilatation of the new choanae in choanal atresia repair. It eliminates the need for stenting and may be a satisfactory alternative for other maneuvers.