Ramsden James D, Campisi Paolo, Forte Vito
ENT Department, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU, UK.
Otolaryngol Clin North Am. 2009 Apr;42(2):339-52, x. doi: 10.1016/j.otc.2009.01.001.
Congenital narrowing of the nasal airway at the posterior choanae, which can be uni- or bilateral, is an uncommon condition in pediatric patients. The surgical management of choanal atresia varies widely in different centers. This article discusses the different surgical strategies including: dilation and stenting; trans-palatal repair; and transnasal resection utilizing endoscopic sinus surgery (ESS) techniques. The merits of stents, lasers, CT-guided surgery, and the use of additional agents including mitomycin C are reviewed, as well as the particular problems associated with managing bilateral choanal atresia in neonates.
后鼻孔处先天性鼻气道狭窄,可为单侧或双侧,在儿科患者中是一种罕见病症。不同中心对后鼻孔闭锁的手术治疗差异很大。本文讨论了不同的手术策略,包括:扩张和支架置入;经腭修复;以及利用鼻内镜鼻窦手术(ESS)技术进行经鼻切除。文中还综述了支架、激光、CT引导手术以及包括丝裂霉素C在内的其他药物的优点,以及新生儿双侧后鼻孔闭锁治疗中存在的特殊问题。