Neonatal Choanal Atresia: A Series of 13 Cases

Abstract

Choanal atresia is a congenital disease that Is manifested at birth when it is bilateral. Unilateral forms can be observed later in life as they are usually well tolerated. Choanal atresia’s frequency is difficult to estimate. It is estimated to be 1 case per 5000 to 8000 births [1]-[3]. Our work is a retrospective study of the cases of choanal atresia that were managed in the ENT department of the Mohamed VI University Hospital during a period of eleven years from January 2010 to December 2020. We identified 13 cases of choanal atresia. The aim of this work is to analyze the elements of the diagnosis, the indications and the surgical techniques as well as our results of the endonasal endoscopic approach in order to identify a therapeutic strategy. The average age of our patients was 21 days, with extremes ranging from 1 day to 28 days. The maximum number of cases was observed in newborns during the first week of life, with a slight female predominance of 7/6. The sex ratio was 0,85. In our series, the delay was most often short with extremes ranging from day 1 of life to day 22. There were 9 bilateral imperforations (69.23%), and 4 unilateral imperforations (30.77%), 2 on the right side (50%) and 2 on the left side (50%). The diagnosis of choanal atresia was confirmed by computed tomography (CT) and nasal endoscopy. All our patients underwent surgical treatment by endonasal endoscopic approach with calibration with a favorable evolution. Through this study, we concluded that the frequent association with other anomalies requires a clinical and paraclinical evaluation and a long-term follow-up. Nasal endoscopy and CT scan have completely revolutionized the diagnostic and therapeutic approaches of choanal atresia, and the endoscopic endonasal approach remains the best therapeutic choice.