AI Article Synopsis
- The study aimed to evaluate the long-term surgical outcomes of choanal atresia repair in pediatric patients, focusing on various factors influencing success rates.
- Between 1996 and 2010, 42 patients underwent surgical procedures, with a follow-up duration averaging 6.3 years; only 31 had their initial repair performed by the same faculty, resulting in a total of 43 subsequent endoscopic surgeries.
- The findings revealed a low revision surgery rate (21% for those operated on) and indicated that additional treatments like mitomycin C, stenting, or dilation did not significantly impact the success of the initial surgical repairs.
Article Abstract
Objective: To analyze factors affecting 15-year surgical outcomes of choanal atresia repair.
Design: Case series.
Setting: Tertiary care pediatric hospital.
Patients: Between April 17, 1996, and March 23, 2010, a total of 42 patients aged 3 days to 15 years underwent endoscopic or transpalatal choanal atresia repair by our pediatric otolaryngology faculty.
Main Outcome Measures: Reoperation and restenosis rates, with consideration of effects of mitomycin C therapy, stenting, and postoperative dilation.
Results: Three of 42 patients were excluded because of inadequate follow-up data; the follow-up time for the remaining 39 patients averaged 6.3 years (range, 1-14.9 years). Excluding 6 patients whose initial repair was performed by other physicians, 31 of 33 patients in whom we performed initial repair had a total of 43 endoscopic surgical procedures (19 patients had unilateral procedures, and 12 patients had bilateral procedures), and the other 2 underwent bilateral transpalatal repair. Of the total 43 sides we operated on endoscopically, 9 sides (21%) required revision surgery, including excision of scar tissue or additional drilling of persistent bony stenosis. No significant difference was observed in the rate of restenosis among cases treated endoscopically with mitomycin C (22 of 43 operative sides, P = .13), with stenting (36 of 43 operative sides, P = .99), or with subsequent dilation (P = .45). When we used stents, they were usually (in 28 of 36 patients) left in place for 15 days or longer.
Conclusion: Our revision rate after initial endoscopic repair of choanal atresia was low and was unaffected by adjuvant mitomycin C therapy or stenting.
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| http://dx.doi.org/10.1001/jamaoto.2013.1111 | DOI Listing |
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