Transnasal endoscopic approach in repair of choanal atresia

INTRODUCTION: The aim of the surgical treatment in choanal atresia is to open the posterior nasal aperture priformis. For this purpose, many methods have been applied to date, and the transnasal endoscopic approach has been the preferred method in recent years and used in our study.
METHODS: Between 1996 and 2017, transnasal endoscopic surgery was performed in six patients with the diagnosis of unilateral choanal atresia, atresia plaque resection and stent placement were performed in two patients, and stentless atresia plaque and posterior vomer resection operations were performed in four patients. Our patients were followed for at least 2 years and their results were evaluated.
RESULTS: Choanal atresia was unilateral in all of our patients. Four of six patients were male and two were female. Our youngest patient was 7 years old, and our oldest patient was 22 years old, with a mean age of 13.6 years. Of the atresia plaques, four were osseomembranous and two were membranous. Adequate choanal patency was achieved in our patients who underwent atretic plaque and posterior vomer resection and did not use a stent. Restenosis developed in patients who underwent atretic plaque resection and used stent. In these patients, stent-free, posterior vomer resection was performed in revision surgery.
DISCUSSION AND CONCLUSION: We believe that in the treatment of choanal atresia, atretic plaque and posterior vomer resection with the help of transnasal endoscopic surgery gives successful results, and the choanal opening opened without stenting provides adequate nasal breathing.