Endoscopic transeptal surgery for choanal atresia with a stentless folded-over-flap technique

Abstract

OBJECTIVE: To analyze long-term results of a new stentless surgical technique for choanal atresia that also used no packing. STUDY DESIGN: Prospective study. METHODS: Ten patients (3 bilateral and 7 unilateral), with ages ranging from 4 days to 30 years, were operated on. The follow-up was 6 months to 36 months. This approach allowed resection of the posterior portion of the vomer, atretic plate, and part of the medial pterygoid process. Flaps were fashioned from septal, nasal, and pharyngeal mucosa from the atretic plates and fixed with fibrin glue. Postoperative control included nasal endoscopy and computerized tomography (CT). RESULTS: Adequate functional nasal breathing was maintained during follow-up. CONCLUSIONS: This technique was satisfactory and safe, allowing fast recovery in a one-step surgery, using neither stents nor nasal packing. Long-term patency with no reduction in functional quality was also observed.