Navigation-assisted endoscopic U-flap technique and steroid-eluting stent for choanal atresia repair

IF 1.2 4区医学 Q3 OTORHINOLARYNGOLOGY

International journal of pediatric otorhinolaryngology Pub Date : 2025-02-01 DOI:10.1016/j.ijporl.2025.112217

Jing-Ying Wen , Zhe-Zheng Wang , Fei-Xiong Zhen , Hong-Tao Zhen

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引用次数: 0

Abstract

Objectives

Surgery is the only treatment for congenital choanal atresia (CCA). It is crucial to avoid postoperative restenosis or re-occlusion of the neo-choana. This study investigated the efficacy of a navigation-assisted endoscopic endonasal U-flap technique and a bioabsorbable steroid-eluting stent for CCA repair.

Methods

A retrospective analysis was performed on 26 patients with CCA, divided into two groups (Group A and Group B). All the patients underwent navigation-assisted endoscopic endonasal resection of the atretic plate. In Group A, a silicone tube was placed to support the neo-choana and retained for 3 weeks, while in Group B, double U-flaps combined with a bioabsorbable steroid-eluting stent were used to support the flaps and the neo-choana. From the 4th week after surgery, the patients were given a budesonide inhalation suspension via transnasal nebulization for 4 weeks. Fiberoptic nasopharyngoscopy was performed at the 4th week, the 6th week, 2 months, 3 months and 6 months after surgery to observe surgical complications and neo-choana patency. The number of cases of restenosis and the number of complications occurring post-operatively were recorded for both groups.

Results

The operation success rate in Group A was 63.6 % (7/11), while the operation success rate in Group B was 100 % (15/15). There was a significant difference in the success rate between the two groups (P < 0.05). Patients in Group B exhibited a higher operation success rate, a more comfortable postoperative experience and an absence of complications.

Conclusion

Navigation-assisted endoscopic endonasal resection of the atretic plate with two U-shaped mucoperiosteal flaps, a steroid-eluting stent, and post-operative transnasal glucocorticoid nebulization is a minimally invasive, precise and safe technique that is more effective in maintaining the patency of the neo-choana and is less recurrent in patients with CCA.

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来源期刊

International journal of pediatric otorhinolaryngology 医学-耳鼻喉科学

CiteScore

3.20

自引率

6.70%

发文量

276

审稿时长

62 days

期刊介绍： The purpose of the International Journal of Pediatric Otorhinolaryngology is to concentrate and disseminate information concerning prevention, cure and care of otorhinolaryngological disorders in infants and children due to developmental, degenerative, infectious, neoplastic, traumatic, social, psychiatric and economic causes. The Journal provides a medium for clinical and basic contributions in all of the areas of pediatric otorhinolaryngology. This includes medical and surgical otology, bronchoesophagology, laryngology, rhinology, diseases of the head and neck, and disorders of communication, including voice, speech and language disorders.