EVALUATION OF TRANS-NASAL ENDOSCOPIC CROSS-OVER FLAP TECHNIQUE IN THE REPAIR OF CHOANAL ATRESIA

Abstract

Background: Choanal atresia (CA) is a widely recognized craniofacial disorder characterized by the obliteration of the posterior nasal opening, due to the imperforation of the oronasal membrane and overgrowth of the horizontal and vertical process of the palatine bone during weeks 4-11 of the gestation process. Objective: To evaluate the efficacy of trans-nasal endoscopic cross-over flap technique in the repair of choanal atresia with long-term follow-up. Patients and methods: This study was conducted on 20 choanal atresia cases that were managed by the endoscopic transnasal approach using cross-over flap technique at the Department of Otorhinolaryngology, Bab EL-Sharia and AL-Hussein Hospitals, Faculty of Medicine, AL-Azhar University from December 2018 to January 2020. Results: The study included 20 cases: 13 females and 7 males, 5 cases were bilateral, 15 cases were unilateral. Four cases were bony atretic plate, and 16 cases were mixed atretic plate. Four cases (20%) needed post-operative revision repair due to restenosis of the choana. Revision was more common in bilateral cases than unilateral cases and in bony type than mixed type. Also, revision was common in patients with associated malformations, and in patients done before 10 days. Conclusion: Transnasal endoscopic surgery using cross-over flap technique is one of the best choices in the management of the choanal atresia. Endoscopy and CT are the methods of choice for diagnosis.