A national study of choanal atresia in tertiary care centers in Canada – part II: clinical management

Journal of Otolaryngology - Head & Neck Surgery

Lily H. P. Nguyen¹  Jennifer M. Siu²  Evan Jon Propst²  Agnieszka Dzioba³  Murad Husein⁴  Josee Paradis⁴  Hamdy El-Hakim⁵  Frederick K. Kozak⁶  Demitri Perera⁷  Paul Hong⁸  Monika Wojtera⁹ 

[1] Department of Otolaryngology – Head and Neck Surgery, McGill University, Montreal, Canada;Institute for Health Science Education, McGill University, Montreal, Canada;Department of Pediatric Surgery, Montreal Children’s Hospital, Montreal, Canada;Department of Otolaryngology–Head & Neck Surgery, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada;Department of Paediatric Otolaryngology- Head and Neck Surgery, Children’s Hospital at London Health Sciences Centre, London, ON, Canada;Department of Paediatric Otolaryngology- Head and Neck Surgery, Children’s Hospital at London Health Sciences Centre, London, ON, Canada;Otolaryngology-Head and Neck Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada;Division of Pediatric Surgery and Otolaryngology Head and Neck Surgery, Departments of Surgery and Pediatrics, The Stollery Children’s Hospital, University of Alberta Hospital, Edmonton, AB, Canada;Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada;Division of Pediatric Otolaryngology-Head and Neck Surgery, BC Children’s Hospital, Vancouver, BC, Canada;Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia;IWK Health Centre, Halifax, NS, Canada;Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Dalhousie University, Halifax, NS, Canada;Otolaryngology-Head and Neck Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada;

关键词: Choanal atresia;    Surgical repair;    Post-operative management;    Planned second look;    Surgical adjuncts;   

DOI  :  10.1186/s40463-021-00503-3

来源: Springer

【 摘 要 】

BackgroundTo evaluate the clinical management of choanal atresia (CA) in tertiary centers across Canada.MethodsMulti-centre case series involving six tertiary care pediatric hospitals across Canada. Retrospective chart review of patients born between 1980 and 2010 diagnosed with choanal atresia to a participating center.ResultsThe health charts of 215 patients (59.6% female) with choanal atresia (CA) were reviewed. Mean age of initial surgical repair was 0.8 months for bilateral CA, and 48.6 months for unilateral CA. Approaches of surgical repair consisted of endoscopic transnasal (31.7%), non-endoscopic transnasal (42.6%), and transpalatal (25.2%). Stents were used on 70.7% of patients. Forty-nine percent of patients were brought back to the OR for a planned second look; stent removal being the most common reason (86.4%). Surgical success rate of initial surgeries was 54.1%. Surgical technique was not associated with rate of restenosis [χ2 (2) = 1.6, p = .46].ConclusionsThe present study is the first national multi-institutional study exploring the surgical outcomes of CA over a 30-year period. The surgical repair of CA presents a challenge to otolaryngologists, as the rate of surgical failure is high. The optimal surgical approach, age at surgical repair, use of stents, surgical adjuncts, and need for planned second look warrant further investigation.Graphical abstract

【 授权许可】

CC BY