[Clinical application of mucosal flap technique combined with a corticosteroid-eluting stents in bony nasal stenosis].

Objective

To summarize the clinical outcomes of endoscopic mucosal flap technique combined with absorbable corticosteroid drug-eluting stent in children with congenital bony nasal stenosis.

Methods

A retrospective review was performed on 9 children（age 7 days to 5 years） treated from January 2019 to July 2025. Among them, there were 6 cases of congenital choanal atresia and 3 cases of congenital nasal pyriform aperture stenosis （CNPAS）. Except for 1 case of stenosis of the nasal meatus treated conservatively, the rest were treated by endoscopic choanal atresia repair. During surgery, mucosa over the atretic plate was preserved and fashioned into mucosal flaps to cover raw surfaces; partial vomer removal was performed when necessary to enlarge the neochoana, followed by placement of an absorbable corticosteroid drug-eluting stent for support, flap stabilization, and local anti-inflammation. Follow-ups were scheduled at 2 weeks, 1, 2, 3 and 6 months, and thereafter, assessing nasal patency, feeding/sleeping, endoscopic findings, and restenosis/reatrestia.

Results

Among 6 choanal atresia cases, 5 remained patent without reatrestia during follow-up, while 1 complete bony case developed reatrestia and was deemed a failure. Among 3 pyriform aperture stenosis cases, the conservatively managed child had prolonged symptoms（20 days） after upper respiratory infections requiring intranasal medications, whereas the two surgically treated children achieved resolution of nasal obstruction and normal feeding.

Conclusion

Endoscopic mucosal flap technique combined with absorbable corticosteroid drug-eluting stent may provide favorable patency maintenance and mucosal healing in most children with congenital bony nasal stenosis, while complete bony choanal atresia remains at high risk of reatrestia.