선천성 후비공 폐쇄증: 7예의 분석

Abstract

Background and Objectives：Congenital choanal atresia is a relatively uncommon disease whose causes can be explained by embryological etiology. To date, many authors have expressed various opinions about the timing of surgery and surgical approach. We retrospectively analyzed 7 cases of congenital choanal atresia to find out the treatment results and to propose the timing of surgery and the method of surgical approach. Materials and Methods：Seven congenital choanal atresia patients who had been treated between 1981 to 1997 were retrospectively analyzed with charts and X-ray reviews. The symptoms, associated anomalies, site of atresia, features of the atretic plate, surgical approaches, duration and materials used for stenting, reoperation, duration and results of follow-up were analyzed. Five patients were female and 2 patients were male. Associated anomalies were observed in 1 case (14%). Of 6 patients who underwent surgery, 3 received transnasal approach the other 3 received the transpalatal approach. The atretic site was bilateral in 5 cases (71%) and unilateral in 2 cases (29%). Stent was used in all surgical cases. Results：Of the 10 sides evaluated, bony atresia was observed in 3 sides (30%), membranous atresia in 2 sides (20%), and mixed bony-membranous atresia in 5 sides (50%). Three patients who were treated by transpalatal approach and 1 patient who was treated by transnasal approach were successfully treated without reoperation. Two newborn patients who were treated by transnasal approach could achieve normal growth and development by mouth feeding and nasal breathing. They had granulation tissue or stenosis of the opening but they were successfully treated by reoperation and longer period of stenting. Conclusion：We recommend that neonatal congenital choanal atresia patients should be treated by transnasal approach with longer periods of stenting immediately following the diagnosis. (Korean J Otolaryngol 2000;43:296-9)