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后鼻孔闭锁的内镜治疗

Endoscopic treatment of choanal atresia.

作者信息

Llorente José Luis, López Fernando, Morato Marta, Suárez Vanessa, Coca Andrés, Suárez Carlos

机构信息

Servicio de Otorrinolaringología, Instituto Universitario de Oncología del Principado de Asturias, Hospital Universitario Central de Asturias, Oviedo, Asturias, España.

出版信息

Acta Otorrinolaringol Esp. 2013 Nov-Dec;64(6):389-95. doi: 10.1016/j.otorri.2013.05.001. Epub 2013 Jul 27.

Abstract

INTRODUCTION

Choanal atresia (CA) is an infrequent congenital obliteration of the airway at the level of the posterior nasal aperture resulting in the absence of connection between the nasal cavity and the aerodigestive tract. We present our experience with an endoscopic technique for congenital CA without the use of intranasal stents.

MATERIAL AND METHOD

We analysed a series of 10 patients with CA treated in our department from 2006 to 2012 through endoscopic surgery. We present a description of the sample and the surgical technique used.

RESULTS

The sample consisted of 5 men and 5 women. Mean patient age was 8 years (range: 5 days-32 years). Fifty percent of patients were cases with re-stenosis requiring revision surgery. Bilateral presentation was 7 and unilateral was 3. All CA were mixed (bony-membranous). Fifty per cent of patients had an associated malformation. All patients underwent nasal endoscopic surgery without stenting. After a mean follow up of 27 months (range: 11-78 months), the success rate was 100%. No complications were observed.

CONCLUSION

Transnasal endoscopic repair for both unilateral and bilateral CA without intranasal stenting was found to be a safe, expedient procedure that afforded minimal complications with a high success rate. Endoscopic endonasal surgery may be considered as the mainstay of treatment.

摘要

引言

后鼻孔闭锁(CA)是一种罕见的先天性气道在鼻后孔水平的闭塞,导致鼻腔与气消化道之间缺乏连接。我们介绍了一种不使用鼻内支架的先天性CA内镜技术的经验。

材料与方法

我们分析了2006年至2012年在我院接受内镜手术治疗的10例CA患者。我们描述了样本和所使用的手术技术。

结果

样本包括5名男性和5名女性。患者平均年龄为8岁(范围:5天至32岁)。50%的患者为再狭窄病例,需要进行翻修手术。双侧病例为7例,单侧病例为3例。所有CA均为混合型(骨性-膜性)。50%的患者伴有相关畸形。所有患者均接受了无支架的鼻内镜手术。平均随访27个月(范围:11至78个月)后,成功率为100%。未观察到并发症。

结论

发现经鼻内镜修复单侧和双侧CA且不使用鼻内支架是一种安全、便捷的手术,并发症极少,成功率高。内镜鼻内手术可被视为主要治疗方法。

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