Choanal atresia surgery: outcomes in 42 patients over 20 years and a review of the literature.

BACKGROUND: Choanal Atresia (CA) is potentially life-threatening and its repair has a variable revision rate.

OBJECTIVES: A case series study from 1997 to 2017 to evaluate the results of repair of CA and review factors affecting outcome.

METHODS: Forty-two patients aged one day to 16 years were included. The outcome measures were the number of revision operations and the length of time over which surgery was required. A focused review of the recent literature (2000-2018) was done.

RESULTS: Bilateral cases (17) had a mean of 5.24 operations compared to 2.2 operations in unilateral cases (25). Nine patients had bony CA and required 3.56 operations, twenty-four patients had mixed CA and required 3.58 operations. Twelve patients with comorbidities required more operations. Patients with reflux disease required a mean of 4.67 operations.

CONCLUSION: An increased rate of restenosis was found in patients with bilateral CA, GERD and those with comorbidities. Parents should be counselled regarding the likelihood of revision surgery. Use of stents or Mitomycin C did not impact the revision rate in this series.