[On the issue of classification of vomer deformities in children].

Abstract

Numerous publications on the classification of the nasal septum deformity (deviation) are mainly related to the anterior septal parts and the development of this pathology in the adult population. None of the available classifications contain the detail of the vomer deformities, required to select an algorithm for subsequent doctor's actions, as well as considering the clinical and anatomical features of this zone in children with congenital choanal atresia (CCA) or in its isolated deformity.

Objective: To develop the classification of the vomer's deformities variants based on an analysis of CT of the paranasal sinuses (PNSs) in children with CCA and isolated deformity of the vomer, determining the choice of tactical and technical surgical treatment options.

Material and methods: The classification is based on analysis of computed tomography of the PNSs of 334 children with CCA and isolated vomer deformity.

Results: The vomer displacement towards the injured side was observed in the unilateral form of choanal atresia, thus arcuate, angular and lateral vomer displacement was revealed in the coronal plane. The following variants of the vomer deformity have been identified in the assessment of axial plane: S-shaped displacement towards the atresia when unilateral or towards one of sides, angular displacement by the type of crista, uniform displacement towards atresia, hyperplasia of the vomer's posterior edge, splitting of the vomer. The proposed classification systematizes numerous variants of the vomer's deformities, defined in the axial and coronal planes.

Conclusion: The classification is the basis of the algorithm for selecting technical options and methods of surgical treatment of patients with CCA, choanal stenosis and isolated vomer deformity.