A national study of choanal atresia in tertiary care centers in Canada – part II: clinical management
Abstract Background To evaluate the clinical management of choanal atresia (CA) in tertiary centers across Canada. Methods Multi-centre case series involving six tertiary care pediatric hospitals across Canada. Retrospective chart review of patients born between 1980 and 2010 diagnosed with choanal...
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2021-07-01
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| Series: | Journal of Otolaryngology - Head and Neck Surgery |
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| Online Access: | https://doi.org/10.1186/s40463-021-00503-3 |
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doaj-83a2e795036f45f193525e1b7506bd2f2021-07-18T11:11:06ZengBMCJournal of Otolaryngology - Head and Neck Surgery1916-02162021-07-015011710.1186/s40463-021-00503-3A national study of choanal atresia in tertiary care centers in Canada – part II: clinical managementJosee Paradis0Agnieszka Dzioba1Hamdy El-Hakim2Paul Hong3Frederick K. Kozak4Lily H. P. Nguyen5Demitri Perera6Evan Jon Propst7Jennifer M. Siu8Monika Wojtera9Murad Husein10National Choanal Atresia Study Working GroupDepartment of Paediatric Otolaryngology- Head and Neck Surgery, Children’s Hospital at London Health Sciences CentreDepartment of Paediatric Otolaryngology- Head and Neck Surgery, Children’s Hospital at London Health Sciences CentreDivision of Pediatric Surgery and Otolaryngology Head and Neck Surgery, Departments of Surgery and Pediatrics, The Stollery Children’s Hospital, University of Alberta HospitalIWK Health CentreFaculty of Medicine, University of British ColumbiaDepartment of Otolaryngology – Head and Neck Surgery, McGill UniversityFaculty of Medicine, University of QueenslandDepartment of Otolaryngology–Head & Neck Surgery, Hospital for Sick Children, University of TorontoDepartment of Otolaryngology–Head & Neck Surgery, Hospital for Sick Children, University of TorontoOtolaryngology-Head and Neck Surgery, Schulich School of Medicine and Dentistry, Western UniversityDepartment of Paediatric Otolaryngology- Head and Neck Surgery, Children’s Hospital at London Health Sciences CentreAbstract Background To evaluate the clinical management of choanal atresia (CA) in tertiary centers across Canada. Methods Multi-centre case series involving six tertiary care pediatric hospitals across Canada. Retrospective chart review of patients born between 1980 and 2010 diagnosed with choanal atresia to a participating center. Results The health charts of 215 patients (59.6% female) with choanal atresia (CA) were reviewed. Mean age of initial surgical repair was 0.8 months for bilateral CA, and 48.6 months for unilateral CA. Approaches of surgical repair consisted of endoscopic transnasal (31.7%), non-endoscopic transnasal (42.6%), and transpalatal (25.2%). Stents were used on 70.7% of patients. Forty-nine percent of patients were brought back to the OR for a planned second look; stent removal being the most common reason (86.4%). Surgical success rate of initial surgeries was 54.1%. Surgical technique was not associated with rate of restenosis [χ2 (2) = 1.6, p = .46]. Conclusions The present study is the first national multi-institutional study exploring the surgical outcomes of CA over a 30-year period. The surgical repair of CA presents a challenge to otolaryngologists, as the rate of surgical failure is high. The optimal surgical approach, age at surgical repair, use of stents, surgical adjuncts, and need for planned second look warrant further investigation. Graphical abstracthttps://doi.org/10.1186/s40463-021-00503-3Choanal atresiaSurgical repairPost-operative managementPlanned second lookSurgical adjuncts |
| collection |
DOAJ |
| language |
English |
| format |
Article |
| sources |
DOAJ |
| author |
Josee Paradis Agnieszka Dzioba Hamdy El-Hakim Paul Hong Frederick K. Kozak Lily H. P. Nguyen Demitri Perera Evan Jon Propst Jennifer M. Siu Monika Wojtera Murad Husein National Choanal Atresia Study Working Group |
| spellingShingle |
Josee Paradis Agnieszka Dzioba Hamdy El-Hakim Paul Hong Frederick K. Kozak Lily H. P. Nguyen Demitri Perera Evan Jon Propst Jennifer M. Siu Monika Wojtera Murad Husein National Choanal Atresia Study Working Group A national study of choanal atresia in tertiary care centers in Canada – part II: clinical management Journal of Otolaryngology - Head and Neck Surgery Choanal atresia Surgical repair Post-operative management Planned second look Surgical adjuncts |
| author_facet |
Josee Paradis Agnieszka Dzioba Hamdy El-Hakim Paul Hong Frederick K. Kozak Lily H. P. Nguyen Demitri Perera Evan Jon Propst Jennifer M. Siu Monika Wojtera Murad Husein National Choanal Atresia Study Working Group |
| author_sort |
Josee Paradis |
| title |
A national study of choanal atresia in tertiary care centers in Canada – part II: clinical management |
| title_short |
A national study of choanal atresia in tertiary care centers in Canada – part II: clinical management |
| title_full |
A national study of choanal atresia in tertiary care centers in Canada – part II: clinical management |
| title_fullStr |
A national study of choanal atresia in tertiary care centers in Canada – part II: clinical management |
| title_full_unstemmed |
A national study of choanal atresia in tertiary care centers in Canada – part II: clinical management |
| title_sort |
national study of choanal atresia in tertiary care centers in canada – part ii: clinical management |
| publisher |
BMC |
| series |
Journal of Otolaryngology - Head and Neck Surgery |
| issn |
1916-0216 |
| publishDate |
2021-07-01 |
| description |
Abstract Background To evaluate the clinical management of choanal atresia (CA) in tertiary centers across Canada. Methods Multi-centre case series involving six tertiary care pediatric hospitals across Canada. Retrospective chart review of patients born between 1980 and 2010 diagnosed with choanal atresia to a participating center. Results The health charts of 215 patients (59.6% female) with choanal atresia (CA) were reviewed. Mean age of initial surgical repair was 0.8 months for bilateral CA, and 48.6 months for unilateral CA. Approaches of surgical repair consisted of endoscopic transnasal (31.7%), non-endoscopic transnasal (42.6%), and transpalatal (25.2%). Stents were used on 70.7% of patients. Forty-nine percent of patients were brought back to the OR for a planned second look; stent removal being the most common reason (86.4%). Surgical success rate of initial surgeries was 54.1%. Surgical technique was not associated with rate of restenosis [χ2 (2) = 1.6, p = .46]. Conclusions The present study is the first national multi-institutional study exploring the surgical outcomes of CA over a 30-year period. The surgical repair of CA presents a challenge to otolaryngologists, as the rate of surgical failure is high. The optimal surgical approach, age at surgical repair, use of stents, surgical adjuncts, and need for planned second look warrant further investigation. Graphical abstract |
| topic |
Choanal atresia Surgical repair Post-operative management Planned second look Surgical adjuncts |
| url |
https://doi.org/10.1186/s40463-021-00503-3 |
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