Coniglio J U, Manzione J V, Hengerer A S
Division of Otolaryngology-Head and Neck Surgery, University of Rochester, School of Medicine and Dentistry, New York 14642.
Ann Otol Rhinol Laryngol. 1988 Sep-Oct;97(5 Pt 1):448-53. doi: 10.1177/000348948809700503.
The CHARGE association is a collection of multisystem congenital anomalies including choanal atresia. A review of the literature failed to identify any specific findings that suggested the need to alter the management of choanal atresia in these patients. Our review of 24 patients with choanal atresia managed between 1974 and 1986 identified nine patients with the CHARGE criteria. These nine patients demonstrated a higher prevalence of surgical failures than the patients without the CHARGE association. The reasons are discussed, and computed tomographic scans demonstrate the anatomic findings of a more contracted nasopharynx and narrowed posterior choanal region. Thus, successful repairs require a more radical resection of the posterior nasal septum and lateral bony walls that can be achieved only with a transpalatal approach. The preoperative airways of CHARGE association patients are also at increased risk of obstruction and may require intubation or tracheotomy during the early life of the patient.
CHARGE综合征是一组包括后鼻孔闭锁在内的多系统先天性异常。文献回顾未能发现任何表明需要改变这些患者后鼻孔闭锁治疗方法的具体发现。我们对1974年至1986年间接受治疗的24例后鼻孔闭锁患者进行回顾，发现9例符合CHARGE综合征标准。这9例患者手术失败的发生率高于无CHARGE综合征的患者。文中讨论了其原因，计算机断层扫描显示鼻咽部更狭窄、后鼻孔区域变窄的解剖学表现。因此，成功修复需要更彻底地切除后鼻中隔和外侧骨壁，这只有通过经腭入路才能实现。CHARGE综合征患者的术前气道梗阻风险也增加，在患者早期生活中可能需要插管或气管切开术。
