Choanal atresia: endoscopic trans-nasal approach

Transnasal endoscopic repair of bilateral congenital choanal atresia: controversies

OBJECTIVE

To evaluate current concerns about transnasal endoscopic repair of bilateral congenital choanal atresia, regarding technical difficulties, prognostic factors and important controversies.

PATIENTS AND METHODS

Ten infants with bilateral congenital choanal atresia, aged from 3 to 27 days (mean, 11.2 days) were included. All cases underwent transnasal endoscopic repair and were clinically and endoscopically monitored.

RESULTS

Of the seven patients treated with stenting, five remained patent and two required minor debridement (with complete patency thereafter). Of the three patients treated without stenting, one remained patent and two required minor debridement (with patency thereafter).

CONCLUSIONS

Transnasal endoscopic repair of bilateral congenital choanal atresia is a safe and successful technique. The use of powered instrumentation in neonatal patients requires experience and a correctly sized drill. Stenting with an appropriate nasal tube for a suitable period is favoured, especially in hospitalised patients.

Choanal atresia in a Himalayan cat--first reported case and successful treatment

A 2-year-old Himalayan cat was presented for investigation of chronic, persistent, unilateral nasal discharge that was unresponsive to antibiotics. Unilateral choanal atresia was diagnosed on nasopharyngoscopy. Following surgical repair using the transnasal route and temporary stenting all clinical signs resolved. This is the first reported case of choanal atresia in a cat. It serves to alert practitioners to the occurrence of this unusual condition which should be included in the differential diagnoses of upper respiratory tract signs in young cats.