Yildirim Zeynep Baysal, Akdağ Mehmet, Çelik Feyzi, Baysal Elif
*Department of Anesthesiology and Reanimation†Department of ENT, Faculty of Medicine, Dicle University, Diyarbakir‡Department of ENT, Faculty of Medicine, Inönü University, Malatya, Turkey.
J Craniofac Surg. 2016 Nov;27(8):1991-1994. doi: 10.1097/SCS.0000000000003086.
In this study, the anaesthetic management of newborn and infant patients who underwent surgery for choanal atresia between 2009 and 2016 is discussed in the light of recently published literature.
The diagnoses, demographic data, anaesthetic risk and duration, additional anomalies, airway management, and complications that arose in 41 patients with choanal atresia who were operated on between 2009 and 2016 were evaluated retrospectively by examining their medical and anaesthesia records.
The patients were divided into 2 groups: Group I-bilateral choanal atresia and Group II-unilateral choanal atresia. Of the 41 patients included in the study, 24 (58.53%) were in the bilateral group, and 17 (41.46%) were in the unilateral group. Fifteen (34.1%) of the patients were male, and 26 (59.1%) of the patients were female. The mean age of the 24 patients in Group I was 25.86 days (3-72), and the mean age of the 17 patients in Group II was 171.08 days (81-365). Additional congenital anomalies were present in 13 of the patients in the bilateral choanal atresia group and 3 of the patients in the unilateral choanal atresia group.Seven patients from Groups I and 2 patients from Group II were determined to have difficult airways. The laryngoscopic images from these patients were classified as grades 3 and 4 according to the Cormack-Lehane classification system. When the durations of anesthesia in the groups were compared, the duration of anesthesia in Group I was found to be significantly longer (Table 3). Anesthesia-related complications were observed in 9 patients (37.5%) from the bilateral choanal atresia group and in 4 patients (2.3%) from the unilateral atresia group. Steroids were used as prophylactics in these patients.
Congenital anomalies and their associated risks, as well as intubation and ventilation problems and the complications that might arise, must be considered in addition to anesthetic management when repairing choanal atresia in newborn and infant patients.
在本研究中，根据最近发表的文献，讨论了2009年至2016年间接受后鼻孔闭锁手术的新生儿和婴儿患者的麻醉管理。
通过检查41例2009年至2016年间接受后鼻孔闭锁手术患者的医疗和麻醉记录，回顾性评估其诊断、人口统计学数据、麻醉风险和持续时间、其他异常情况、气道管理及出现的并发症。
患者分为两组：I组——双侧后鼻孔闭锁，II组——单侧后鼻孔闭锁。纳入研究的41例患者中，24例（58.53%）在双侧组，17例（41.46%）在单侧组。15例（34.1%）患者为男性，26例（59.1%）患者为女性。I组24例患者的平均年龄为25.86天（3 - 72天），II组17例患者的平均年龄为171.08天（81 - 365天）。双侧后鼻孔闭锁组13例患者和单侧后鼻孔闭锁组3例患者存在其他先天性异常。I组7例患者和II组2例患者被确定为气道困难。根据Cormack - Lehane分类系统，这些患者的喉镜图像被分类为3级和4级。比较两组的麻醉持续时间时，发现I组的麻醉持续时间明显更长（表3）。双侧后鼻孔闭锁组9例患者（37.5%）和单侧闭锁组4例患者（2.3%）观察到与麻醉相关的并发症。这些患者使用了类固醇作为预防措施。
在新生儿和婴儿患者修复后鼻孔闭锁时，除麻醉管理外，还必须考虑先天性异常及其相关风险，以及插管和通气问题及可能出现的并发症。
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