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    Home»Numéro 49 ORIGINAL ARTICAL ENG»CHOANAL ATRESIA : DIAGNOSIS AND MANAGEMENT
    Numéro 49 ORIGINAL ARTICAL ENG

    CHOANAL ATRESIA : DIAGNOSIS AND MANAGEMENT

    ATRÉSIE DES CHOANES : DIAGNOSTIC ET PRISE EN CHAGE THÉRAPEUTIQUE

    I. Achour 1,2, I. Kharrat 1,2, M. Ben Ayed 1,2, W. Thabet 1,2, A. Bouraoui 2,3, M. Mnejja 1,2, B. Hammami 1,2,
    A. Chakroun 1,2, I. Charfeddine 1,2
    1.Department of Otorhinolaryngology-Head and Neck Surgery, Habib Bourguiba University Hospital, Sfax, Tunisia
    2.Sfax Medical School, University of Sfax, Sfax, Tunisia
    3.Department neonatology, Hedi Chaker University Hospital, Sfax, Tunisia

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    Abstract

    Objective: Choanal atresia (CA) is a rare congenital malformation caused by the obliteration of the posterior choanae by an atretic plate. The aim of our study is to describe the diagnosis and management modalities of CA and to determine the factors associated with recurrence.
    Materials and methods: This is a retrospective study based on the medical records of patients with CA managed in our department in the period between 2002 and 2021. We studied the clinical features and management modalities of each patient. For patients who developed a recurrence, we determined the factors associated with recurrence based on a bivariate analysis.
    Results: We studied the medical records of 26 patients with either a bilateral (n=8) or a unilateral (n=16) form of CA. The median age at surgery was two days for bilateral forms and 5 years and 4 months for unilateral forms. At computed tomography scan, CA was mixed (n=20), bony (n=4) or membranous (n=2). All patients underwent intranasal endoscopic surgical treatment using cold instruments alone in membranous forms and combined to the drilling of the atretic plate in bony and mixed forms. The surgical management included the resection of the posterior part of the vomer bone and the placement of nasal stents in 10 and 16 patients respectively. We recorded 6 cases of recurrence requiring a surgical re-intervention. The presence of associated cranio-facial malformations was the only factor associated with recurrence (p=0,001).
    Conclusion: Choanal atresia diagnosis was based on nasal endoscopy and CT scan. Surgical treatment using transnasal endoscopic approach was an effective and safe technique. Associated local malformations was a factor associated with re-stenosis.
    Key words:  Choanal atresia, management, endoscopic surgery, recurrence.

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    ACTUALITÉS
    LES NODULES THYROIDIENS CHEZ L’ENFANT
    LES MUCOCÈLES NASOSINUSIENNES : APPORT DE L’IMAGERIE
    STOMATOLOGICAL AND MAXILLO-FACIAL FEATURES OF MPOX: REPORT OF THE FIRST CONFIRMED CASE IN IVORY COAST
    KYSTE DE LA VALLÉCULE COMPLIQUÉ DE MALNUTRITION AIGÜE SÉVÈRE CHEZ L’ENFANT: CARACTÉRISTIQUES CLINIQUES ET THÉRAPEUTIQUES
    MELANOME MALIN MUQUEUX DU NASOPHARYNX: A PROPOS D’UNE OBSERVATION

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