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This video provides background information regarding the diagnosis and management of choanal atresia and demonstrates the endoscopic repair of a unilateral choanal atresia.
Authors: Alexander Moushey1; Kiley Trott, MD2; Sarah E. Maurrasse, MD2
Voiceover: Vidal Maurrasse
1Yale School of Medicine, New Haven, CT
2Department of Surgery, Section of Pediatric Otolaryngology, Yale School of Medicine, Yale New Haven Children’s Hospital
Endoscopic repair of a unilateral choanal atresia
Surgical repair is generally recommended to restore the normal anatomy, function, and development of the nasal passage. Surgical intervention can be considered either emergent or elective depending on whether the atresia is unilateral or bilateral, and whether the accompanying respiratory symptoms are mild or severe.
Bleeding disorder (relative)
Clinical instability
Microdebrider
Pediatric sinus telescopes
Sinus curette
Endoscopic sinus surgery setup
Hopkins rod sinus endoscopes and tower
Image guidance/navigation
Flexible fiberoptic nasal endoscopy
CT Maxillofacial/Sinus without contrast protocoled for image guidance
Genetic work-up
Septum
Inferior turbinate
Nasal floor
Skull base
Nasopharynx
Bleeding
Re-stenosis
Need for additional surgical intervention
Damage to skull base/CSF leak
None
1. Ramsden JD, Campisi P, Forte V. Choanal atresia and choanal stenosis. Otolaryngol Clin North Am. 2009 Apr;42(2):339-52.
2. Hengerer AS, Brickman TM, Jeyakumar A. Choanal atresia: embryologic analysis and evolution of treatment, a 30-year experience. Laryngoscope (2008) 118(5):862–6.
3. Hengerer AS, Strome M. Choanal atresia: a new embryologic theory and its influence on surgical management. Laryngoscope (1982) 92(8 Pt 1):913–21.
4. Kwong KM. Current Updates on Choanal Atresia. Front Pediatr. 2015;3:52. Published 2015 Jun 9.
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