Congenital choanal atresia treated by transnasal endoscopic approach and stent application effects on surgery success, evaluation of revision surgery incidence and presence of additional abnormality

Objective: Congenital choanal atresia (CCA) is a rare case but in case of bilateral presence it becomes a life-threatening malformation. CCA is accompanied some anomalies. In studies, although many treatment modalities have been applied for many years the biggest problem is still the formation of stenosis and necessity for revision surgery. Transnasal endoscopic choanal atresia surgery(TECAS) is the most preferred method of approach has the highest success rate of surgery today. In our study, TECAS and stent application's efficacy on success rate of surgery and the prevalence of associated anomalies and impact on surgical achievement were investigated retrospectively. Patients and methods: Patients who admitted to Gaziantep University School of Medicine ear, nose and throat (ENT) outpatient clinic and patients who did not undergo CCA surgery before were included in the study. 50 patients diagnosed CCA, 2 of them were excluded from the study because that died at ICU during early post operative follow-up. Patients undergone TECAS adviced control examination regularly and nasal endoscopic examination performed at checks, after a 6-month follow-up surgical results were evaluated concerning the stenosis occured or not. Results: 48 patients undergo TECAS after follow period at 34 of them no stenosis detected so surgical success rate was 70.8%. Among the CCA diagnosed 48 patients at 9(18.8%) of them accompanying various anomalies have been identified. Surgical failure depends at performing surgery at an early age, stent implementation, the presence of bilateral CCA and associated anomalies existence. At 14(29.2%) patients performed TECAS developed stenosis and has been the need for revision surgery Conclusion: Most common method used today to treat the CCA is TECAS. Despite all the technological advances stenosis formation is the biggest problem currently affecting the success of surgery. Factors such as bilateral CCA and associated anomalies that require early surgery has been the most important factor in surgical failure. New treatment strategies to improve surgical success rate and preventing the development of post operative stenosis should be developed.