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国际小儿耳鼻喉科小组(IPOG)共识建议:小儿后鼻孔闭锁的诊断、术前、术中及术后护理

International Pediatric Otolaryngology Group (IPOG) consensus recommendations: Diagnosis, pre-operative, operative and post-operative pediatric choanal atresia care.

作者信息

Moreddu Eric, Rizzi Mark, Adil Eelam, Balakrishnan Karthik, Chan Kenny, Cheng Alan, Daniel Sam J, de Alarcon Alessandro, Hart Catherine, Hartnick Christopher, Inglis Andrew, Leboulanger Nicolas, Pransky Seth, Rahbar Reza, Russell John, Rutter Mike, Sidell Douglas, Smith Richard J H, Soma Marlene, Spratley Jorge, Thompson Dana, Trozzi Marilena, Ward Robert, Wyatt Michelle, Yeung Jeffrey, Zalzal George, Zur Karen, Nicollas Richard

机构信息

La Timone Children's Hospital, Aix-Marseille Université, Marseille, France.

Children's Hospital of Philadelphia, Philadelphia, PA, USA.

出版信息

Int J Pediatr Otorhinolaryngol. 2019 Aug;123:151-155. doi: 10.1016/j.ijporl.2019.05.010. Epub 2019 May 13.

Abstract

OBJECTIVE

To provide recommendations to otolaryngologists and allied physicians for the comprehensive management of young infants who present with signs or symptoms of choanal atresia.

METHODS

A two-iterative delphi method questionnaire was used to establish expert recommendations by the members of the International Otolaryngology Group (IPOG), on the diagnostic, intra-operative, post-operative and revision surgery considerations.

RESULTS

Twenty-eight members completed the survey, in 22 tertiary-care center departments representing 8 countries. The main consensual recommendations were: nasal endoscopy or fiberscopy and CT imaging are recommended for diagnosis; unilateral choanal atresia repair should be delayed after at least age 6 months whenever possible; transnasal endoscopic repair is the preferred technique; long term follow-up is recommended (minimum one year) using nasal nasofiberscopy or rigid endoscopy, without systematic imaging.

CONCLUSION

Choanal atresia care consensus recommendations are aimed at improving patient-centered care in neonates, infants and children with choanal atresia.

摘要

目的

为耳鼻喉科医生及相关科室医生提供关于患有后鼻孔闭锁体征或症状的幼儿综合管理的建议。

方法

采用两轮德尔菲法问卷,由国际耳鼻喉科小组(IPOG)成员就诊断、术中、术后及翻修手术注意事项制定专家建议。

结果

28名成员完成了调查,他们来自代表8个国家的22个三级医疗中心科室。主要的共识性建议为:推荐采用鼻内镜检查或纤维鼻咽喉镜检查及CT成像进行诊断;单侧后鼻孔闭锁修复术应尽可能推迟至至少6个月龄后进行;经鼻内镜修复术是首选技术;建议使用鼻纤维鼻咽喉镜或硬性内镜进行长期随访(至少一年),无需进行系统性影像学检查。

结论

后鼻孔闭锁护理共识性建议旨在改善以患有后鼻孔闭锁的新生儿、婴儿及儿童为中心的护理。

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