Bilateral choanal atresia repair in neonates-A single surgeon experience

Objective: To evaluate the success of the transnasal endoscopic repair of bilateral choanal atresia (BCA) repair in neonates based on a single surgeon's experience. Methods: A retrospective case review was carried out of all neonates with BCA who underwent transnasal endoscopic repair by the senior author (RGB) between September 1993 and September 2009 at the Royal Children's Hospital Melbourne, Australia. Results: Twenty three neonates (18 female and 5 male) aged between 0 and 32 days (mean age, 7.4 days) underwent surgery for BCA between September 1993 and September 2009. Twenty of these patients met the inclusion criteria to calculate success rate of primary surgery. All patients were stented using modified endotracheal tubes for a mean of 75 days (range, 5-158 days). Of the 20 with adequate follow up, 14 patients had successful primary repair (70%). Of the six requiring revision surgery, three had one revision procedure, and three had two revision procedures. All patients were free of recurrence at last follow up. Mean follow up after removal of primary stent was 25.2 months (range, 6.6-77.9 months). Conclusion: Endoscopic transnasal repair is a relatively safe and successful technique. Stenting for 3 months was found to reduce the chance of early restenosis.