Efficacy of endoscopic choanoplasty without stents in children with congenital choanal atresia

Introduction . Over the last decades, various surgical methods have been proposed for the treatment of congenital choanal atresia, but to date there is no consensus on the optimal operation for the treatment of this nosology. This is due to the frequent complication of surgical treatment of children with choanal atresia – restenosis of the newly created choana. Aim . To develop the most optimal method of surgical correction of congenital choanal atresia in children to improve the effectiveness of treatment, prognosis and quality of life. Materials and methods . 157 children aged from 1 day to 17 years with congenital choanal atresia were divided into two groups: Group 1 was represented by previously unoperated children who underwent endoscopic choanoplasty without stents, Group 2 – children with congenital choanal atresia with recurrence (previously underwent choanoplasty with stents) who also underwent stentless choanoplasty. The obtained results were compared between the groups. Results . Bilateral choanal atresia was diagnosed in 61 (38.9%) patients, unilateral – in 96 (61.1%). Among the patients with unilateral choanal atresia, right-sided atresia was recorded in 54 (34.4%) children, left-sided atresia – in 42 (26.7%) of the studied patients. After surgical treatment, comparing the quality of life, indicators between the 1st and 2nd groups, both in the immediate and distant periods, no statistically significant differences were revealed, with the median general health score in the 1st group being 92 (90; 94), in the 2nd group 90 (88; 93) points already one month after surgery. Conclusions . High efficacy of new surgical technologies for the treatment of congenital choanal atresia in children, including the absence of recurrences when using choanotomy without stents in both groups, has been proved.