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Войти в исследования American journal of otolaryngology · 2025
Endoscopic transnasal repair of choanal atresia: clinical characteristics and outcomes from a main tertiary hospital in Syria.
СтатьяНазвание и аннотация: Перевод в очереди
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Alkhouri Diab, Alhomsi Dima, Dandachli Mhd Nabil
Аннотация
INTRODUCTION: Congenital choanal atresia (CA) is a rare malformation that can present as a neonatal emergency or with delayed symptoms in older children. Despite advances in endoscopic transnasal repair, recurrence and restenosis remain major challenges, and evidence from resource-limited countries is scarce. This study reports a 12-year experience managing CA in Syria, highlighting clinical characteristics, surgical outcomes, and prognostic factors for recurrence.
METHODS: This retrospective cohort study included 33 pediatric patients with choanal atresia who underwent endoscopic transnasal repair between 2012 and 2024. Patients were categorized by laterality (unilateral vs. bilateral) and by recurrence status (recurrence vs. non-recurrence) to identify prognostic factors. Demographics, clinical features, surgical details, and outcomes were extracted from medical records.
RESULTS: Of 33 patients, 21 (63.6 %) had bilateral CA and 12 (36.4 %) unilateral. Mean age at diagnosis was 34.5 months, with bilateral cases diagnosed significantly earlier (0.8 months vs. 93.4 months, p < 0.001). Mixed-type atresia predominated (93.9 %). Associated anomalies were present in 27.3 %, with cardiovascular anomalies being the most frequent. Recurrence was observed in 25 % of patients, while postoperative complications occurred in 14.3 %, mainly synechiae. Recurrence was not significantly associated with age, sex, laterality, or adjunctive measures (stents, topical steroids, mitomycin C, or laser).
CONCLUSION: Endoscopic transnasal repair of CA was shown to be safe and effective in a resource-limited setting, with recurrence and complication rates comparable to international reports. Routine use of stents, steroids, mitomycin C, or laser showed no clear benefit, supporting selective rather than standard application. These findings contribute regional data to the global literature and underscore the need for larger multicenter studies to refine prognostic factors and optimize long-term outcomes.
METHODS: This retrospective cohort study included 33 pediatric patients with choanal atresia who underwent endoscopic transnasal repair between 2012 and 2024. Patients were categorized by laterality (unilateral vs. bilateral) and by recurrence status (recurrence vs. non-recurrence) to identify prognostic factors. Demographics, clinical features, surgical details, and outcomes were extracted from medical records.
RESULTS: Of 33 patients, 21 (63.6 %) had bilateral CA and 12 (36.4 %) unilateral. Mean age at diagnosis was 34.5 months, with bilateral cases diagnosed significantly earlier (0.8 months vs. 93.4 months, p < 0.001). Mixed-type atresia predominated (93.9 %). Associated anomalies were present in 27.3 %, with cardiovascular anomalies being the most frequent. Recurrence was observed in 25 % of patients, while postoperative complications occurred in 14.3 %, mainly synechiae. Recurrence was not significantly associated with age, sex, laterality, or adjunctive measures (stents, topical steroids, mitomycin C, or laser).
CONCLUSION: Endoscopic transnasal repair of CA was shown to be safe and effective in a resource-limited setting, with recurrence and complication rates comparable to international reports. Routine use of stents, steroids, mitomycin C, or laser showed no clear benefit, supporting selective rather than standard application. These findings contribute regional data to the global literature and underscore the need for larger multicenter studies to refine prognostic factors and optimize long-term outcomes.