Meleca Joseph B, Anne Samantha, Hopkins Brandon
Department of Otolaryngology - Head and Neck Surgery, The Cleveland Clinic, Cleveland, OH, United States.
Department of Otolaryngology - Head and Neck Surgery, The Cleveland Clinic, Cleveland, OH, United States.
Int J Pediatr Otorhinolaryngol. 2019 Mar;118:185-187. doi: 10.1016/j.ijporl.2019.01.004. Epub 2019 Jan 7.
Choanal atresia (CA) is a rare pediatric congenital disorder resulting in upper airway obstruction and respiratory distress in the setting of obligate nasal breathing in infants. In 2016, a novel technique was reported in the literature utilizing drug-eluting stents to correct CA. However, 2 out of 3 patients in the study required a second operation under general anesthesia. The repeated visits to the operating room for evaluations and debridement under general anesthesia continues to be a concern for increased morbidity and mortality in infants undergoing repair of CA.
A case series of three (3) patients who underwent repair of CA. Outcomes were measured by post-operative, in-office flexible nasoendoscopy.
Each patient was implanted with mometasone furoate drug-eluting stents at the conclusion of the operation. Post-operatively, patients were instructed to perform nasal saline rinses 3-4 times daily. Outpatient follow-up between 6 and 17 months showed patent nasal passages on nasal endoscopy. There were no post-operative complications. Moreover, patients only underwent a single episode of general anesthesia at time of initial repair.
In our study, we report successful outcomes using drugeluting stents for one-stage surgical correction of CA, therefore negating the need for children to undergo multiple subjections to general anesthetics.
后鼻孔闭锁（CA）是一种罕见的儿科先天性疾病，在婴儿必须经鼻呼吸的情况下会导致上呼吸道阻塞和呼吸窘迫。2016年，文献报道了一种利用药物洗脱支架矫正CA的新技术。然而，该研究中的3例患者中有2例需要在全身麻醉下进行二次手术。对于接受CA修复术的婴儿，反复前往手术室在全身麻醉下进行评估和清创仍然是导致发病率和死亡率增加的一个问题。
对3例接受CA修复术的患者进行病例系列研究。通过术后门诊柔性鼻内镜检查来评估结果。
每位患者在手术结束时均植入了糠酸莫米松药物洗脱支架。术后，指导患者每天进行3 - 4次鼻腔盐水冲洗。6至17个月的门诊随访显示鼻内镜检查时鼻道通畅。无术后并发症。此外，患者在初次修复时仅接受了一次全身麻醉。
在我们的研究中，我们报告了使用药物洗脱支架进行CA一期手术矫正的成功结果，因此无需儿童多次接受全身麻醉。
