Roelly P, Roger G, Bellity A, Garabedian E N
Service d'Otorhinolaryngologie, Hôpital d'Enfants Armand Trousseau, Paris.
Ann Pediatr (Paris). 1992 Oct;39(8):479-83.
Diagnosis of choanal atresia should lead to multidisciplinary investigations to look for other malformations which may or may not be part of the CHARGE syndrome. These concomitant defects have an adverse effect on prognosis in patients with choanal atresia. They seem to be more common in patients with bilateral choanal atresia due to a bony septum. Local investigations include nasal fiberoptic endoscopy to obtain a direct view of the atresia and a CT scan study to determine the type of obstruction. In neonates, treatment rests on transnasal perforation of the septum followed by stenting for four to six weeks. However recurrence is common and requires subsequent use of another therapeutic procedure. In patients with failed transnasal perforation or unilateral choanal atresia discovered at a later age, surgery through the palatal route seems to be virtually radical and can be carried out from eight months of age. Recently developed CO2 laser therapy is, in the opinion in of the authors, an elegant and simple means for transnasal treatment of fibrotic restenosis which, in many cases, obviates the need for transpalatal surgery.
后鼻孔闭锁的诊断应引发多学科检查，以寻找可能是或不是CHARGE综合征一部分的其他畸形。这些伴随缺陷对后鼻孔闭锁患者的预后有不利影响。它们在因骨性鼻中隔导致双侧后鼻孔闭锁的患者中似乎更为常见。局部检查包括鼻纤维内镜检查以直接观察闭锁情况，以及CT扫描研究以确定梗阻类型。对于新生儿，治疗基于经鼻鼻中隔穿孔，随后进行四至六周的支架置入。然而，复发很常见，需要随后采用另一种治疗方法。对于经鼻穿孔失败或在较晚年龄发现的单侧后鼻孔闭锁患者，经腭途径手术似乎几乎是根治性的，可在八个月大时进行。作者认为，最近开发的二氧化碳激光疗法是一种用于经鼻治疗纤维化再狭窄的优雅而简单的方法，在许多情况下无需进行经腭手术。
