Sinha Vikas, Talagauara Umesh Samanth, Jha Sushil G, Dadhich Swati
1Sir T. General Hospital, Government Medical College, Bhavnagar, Bhavnagar, Gujarat India.
2Department of ENT, Government Medical College, Bhavnagar, Gujarat India.
Indian J Otolaryngol Head Neck Surg. 2018 Mar;70(1):53-58. doi: 10.1007/s12070-017-1220-4. Epub 2017 Oct 16.
Bilateral Choanal atresia is a medical emergency. Corrective surgery is the mainstay of the treatment. Hegar's dilator was used in all cases to break the bony/membranous atretic plate. The 22 cases of choanal atresia all operated by the first author were included in this study. Eight cases were 1-5 year old with bilateral choanal atresia and all required immediate surgery as they had repeated attacks of respiratory distress and cycle of cyanosis. Eight cases were of CHARGE Syndrome. All the cases were operated under general anaesthesia. Hegar's dilators were used and nasal stents were placed in all cases. Although complete nasal patency was achieved by surgery, in 8 cases, neonates could not survive due to the CHARGE Syndrome. The mortality was unrelated to the surgery. The 14 cases which were not related to CHARGE Syndroma had a good postoperative recovery. 3 cases were above 15 years old with unilateral complete bony/membranous choanal atresia and they presented with continuos nasal discharge. Hegar's dilators are a safe and simple method of surgery for choanal atresia. Nasal stenting is mandatory to prevent restenosis.
双侧后鼻孔闭锁是一种医疗急症。矫正手术是主要的治疗方法。所有病例均使用黑加氏扩张器来打破骨性/膜性闭锁板。本研究纳入了由第一作者主刀手术的22例后鼻孔闭锁病例。8例为1 - 5岁的双侧后鼻孔闭锁患儿，由于反复出现呼吸窘迫和青紫发作，均需要立即手术。8例患有CHARGE综合征。所有病例均在全身麻醉下进行手术。均使用了黑加氏扩张器并放置了鼻支架。尽管手术实现了鼻腔完全通畅，但8例新生儿因CHARGE综合征未能存活。死亡率与手术无关。14例与CHARGE综合征无关的病例术后恢复良好。3例为15岁以上的单侧完全性骨性/膜性后鼻孔闭锁患者，表现为持续性鼻分泌物增多。黑加氏扩张器是一种安全、简单的后鼻孔闭锁手术方法。鼻支架置入对于预防再狭窄是必需的。
