Endoscopic Endonasal Repair of Congenital Choanal Atresia: Predictive Factors of Surgical Stability and Healing Outcomes

Salvatore Ferlito, Antonino Maniaci, Alberto Giulio Dragonetti, Salvatore Cocuzza, Jerome Rene Lechien, Christian Calvo-Henríquez, Juan Maza-Solano, Luca Giovanni Locatello, Sebastiano Caruso, Francesco Nocera, Andrea Achena, Niccolò Mevio, Gabriella Mantini, Giorgio Ormellese, Angelo Placentino and Ignazio La Mantia
Additional contact information
Salvatore Ferlito: Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, E.N.T. Section, University of Catania, 95124 Catania, Italy
Antonino Maniaci: Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, E.N.T. Section, University of Catania, 95124 Catania, Italy
Alberto Giulio Dragonetti: Otolaryngology Unit, 9338 Ospedale Niguarda “Ca’ Granda”, 20162 Milano, Italy
Salvatore Cocuzza: Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, E.N.T. Section, University of Catania, 95124 Catania, Italy
Jerome Rene Lechien: Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), 75009 Paris, France
Christian Calvo-Henríquez: Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), 75009 Paris, France
Juan Maza-Solano: Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), 75009 Paris, France
Luca Giovanni Locatello: Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), 75009 Paris, France
Sebastiano Caruso: Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, E.N.T. Section, University of Catania, 95124 Catania, Italy
Francesco Nocera: Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, E.N.T. Section, University of Catania, 95124 Catania, Italy
Andrea Achena: Otolaryngology Unit, 9338 Ospedale Niguarda “Ca’ Granda”, 20162 Milano, Italy
Niccolò Mevio: Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), 75009 Paris, France
Gabriella Mantini: Otolaryngology Unit, 9338 Ospedale Niguarda “Ca’ Granda”, 20162 Milano, Italy
Giorgio Ormellese: Otolaryngology Unit, 9338 Ospedale Niguarda “Ca’ Granda”, 20162 Milano, Italy
Angelo Placentino: Otolaryngology Unit, 9338 Ospedale Niguarda “Ca’ Granda”, 20162 Milano, Italy
Ignazio La Mantia: Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, E.N.T. Section, University of Catania, 95124 Catania, Italy

IJERPH, 2022, vol. 19, issue 15, 1-10

Abstract: Background: To assess the long-term outcomes and independent predictors of surgical success of a one-stage minimally invasive surgical procedure for congenital choanal atresia (C.C.A.). Methods: a retrospective multicentric study was conducted between 2010 and 2022. An endonasal endoscopic approach was performed in 38 unilateral or bilateral C.C.A. children. All the patients were clinically and radiologically assessed and followed for at least 2 years. Seven outcome measures were applied. Consequently, surgical success was correlated with all the independent variables reported. Results: 18/38 (47.36%) patients presented normal postoperative healing, 8/38 (21.05) had moderate restenosis (<50%), while 12/38 (31.57%) cases were severe (>50%), requiring a surgical revision. No statistical significance was found for average hospital stay between stenosis >50% and <50% patients ( p = 0.802) and postoperative pain ( p = 0.075); instead, the severe restenosis group demonstrated a higher delay of breast suction ( p < 0.001). Among the independent variables predictors of surgical success, the presence of Charge syndrome and rhinopharyngeal stenosis demonstrated higher risks for surgical revision (OR: 4.00, 95% CI: 0.57–28.01, and OR: 2.75, 95% CI: 0.55–13.69, respectively). On the contrary, the hypoplastic inferior turbinate and bilateral C.C.A. showed a lower risk for severe restenosis by a higher endoscopic surgical space and creating a single larger opening (OR: 0.88, 95% CI: 0.22–3.52, and OR: 0.45, 95% CI: 0.10–2.08). Conclusion: Several independent variables could influence the surgical success after C.C.A. endoscopic repair; however, more high-quality evidence is needed to generate an effective predictive model.

Keywords: choanal atresia; transnasal approach; surgical predictors; endoscopic repair; long-term outcomes (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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