Volume 2003, Issue 2

Abstract

Bilateral congenital choanal atresia (CCA) in newbornscarries significant morbidity and mortality. Many surgical approaches have been described for its correction but none of the approaches have proved superior in preventing postoperative granulation tissue and restenosis. Recently, topical Mitomycin C (MMC) has been used intraoperatively to prevent the formation of granulation tissue and restenosis in choanal atresia repair. We report a series of three consecutive patients who underwent bilateral CCA repair and received topical MMC intraoperatively. We have used topical MMC in CCA repair for the first time in Qatar and report the outcome of these patients. Case 1 was a preterm child (29 gestational weeks) who underwent transnasal repair. Case 2 had CHARGE association and case 3 had no other anomalies, both of whom underwent transpalatal repair. In case 1, we had used topical MMC \ during revision surgery with improved outcome. In cases 2 and 3, topical MMC was applied during primary repair and in addition both received a second application selectively at the margins of the choanae 6 weeks after stent removal. Case 3 needed further dilatation of the choanae four months after second application of topical MMC. None of our patients developed any local or systemic side effects. To our knowledge, bilateral CCA repair in a 29 weeks gestational age child has not been reported in the literature. Our study suggests that topical MMC may be a useful adjunctive therapy in choanal atresia repair.

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2003-12-01
2024-03-29
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References

  1. Lazer RH, Younis RT. Transpalatal repair of choanal atresia using telescopes. Arch Otolaryngol Head Neck Surg. 1995; 21::517520.
    [Google Scholar]
  2. Josephson GD, Vickery CL, Giles WC, Gross CW. Transnasal endoscopic repair of congenital choanal atresia: Long term results. Arch Otolaryngol Head Neck Surg. 1998; 124::537540.
    [Google Scholar]
  3. Vickery CL, Gross CW. Advanced drill technology in treatmentof congenital choanal atresia. Otolaryngologic Clinics of North America. 1997; 30::457465.
    [Google Scholar]
  4. Brown OE, Pownell P, Manning SC. Choanal atresia: A newanatomic classification and clinical management applications. Laryngoscope. 1996; 106::97101.
    [Google Scholar]
  5. Krespi YP, Husain S, Levine TM, Reede DL. Sublabialtransseptal repair of choanal atresia or stenosis. Laryngoscope. 1987; 97::14021406.
    [Google Scholar]
  6. Holland W, Surgic WF Jr. Surgical management of choanalatresia: Improved outcome using Mitomycin. Arch Otolaryngol Head Neck Surg. 2001; 127:13751380.
    [Google Scholar]
  7. Ferguson JL, Neel HB III. Choanal atresia: Treatment trents in 47 patients over 33 years. Ann Otol Rhinol Laryngol. 1989; 98::110112.
    [Google Scholar]
  8. Kaplan CL, The CHARGE. Association: Choanal atresia and multible congenital anomalies. Otolaryngologic Clinics of North America. 1989; 22::661672.
    [Google Scholar]
  9. Correa AJ, Reinisch L, Sanders DL, Huang S, Deriso W, Duncavage JA, Garrett CG. Inhibition of of subglottic stenosis with mitomycin-C in the canine model. Ann Otol Rhinol Laryngol. 1999; 108::10531060.
    [Google Scholar]
  10. Eliashar R, Eliachar I, Esclamado R, Gramlich T, Strome M. Can topical mitomycin prevent laryngotracheal stenosis? Laryngoscope. 1999; 109::15941600.
    [Google Scholar]
  11. Jampel HD. Effect of brief exposure to mitimycin C on viability and proliferation of cultured Human Tenon's capsule fibroblasts. Ophthalmology. 1992; 99::14711476.
    [Google Scholar]
  12. Ingrams DR, Volk MS, Biesman BS, Pankratov MM, Shapshay SM. Sinus surgery: Does mitomycin C reduce stenosis? Laryngoscope. 1998; 108::883886.
    [Google Scholar]
  13. Owens H. Observations in treating twenty five cases of choanal atresia by the transpalatine approach. Laryngoscope. 1965; 75::84104.
    [Google Scholar]
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Keyword(s): Choanal atresiacomplicationsmitomycin-Cpostoperative and surgical management

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