S288 – Balloon Dilation for Treatment of Recurrent Choanal Atresia

Abstract

Objectives 1) To investigate alternative methods of maintaining choanal patency in patients with choanal atresia. 2) To assess the feasibility and efficacy of balloon dilation in maintaining patency of repaired choanal atresia. Methods Choanal atresia is the developmental failure of the nasal cavity to communicate with the nasopharynx. Several approaches have been described for primary repair of choanal atresia. A transnasal endoscopic approach has been fully developed and is now the preferred method of primary repair. Restenosis is known to occur after surgical correction and primary patency rates after all surgical procedures have been reported to be 55% to 75%. We reviewed the charts of 3 patients at a single institution with a diagnosis of choanal atresia (2 bilateral, 1 unilateral). All were primarily repaired with traditional methods but subsequently developed restenosis; 1 patient developed complete restenosis of her choanae. All 3 underwent serial endoscopic dilation with sinuplasty balloons. Results After endoscopic serial dilation with the use of sinuplasty balloons, all 3 patients have maintained patent choanae on follow-up examination up to 1 year postoperatively. Conclusions Dilation of a restenosed choanal atresia with sinuplasty balloons may be an effective new application of this technology. The procedure is simple to perform and can be easily repeated to increase long-term patency for these patients.