Reducing the Need for General Anesthesia in the Repair of Choanal Atresia with Steroid-Eluting Stents: A Case Series

Publication date: Available online 7 January 2019

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Joseph B. Meleca, Samantha Anne, Brandon Hopkins

Abstract

Introduction

Choanal atresia (CA) is a rare pediatric congenital disorder resulting in upper airway obstruction and respiratory distress in the setting of obligate nasal breathing in infants. In 2016, a novel technique was reported in the literature utilizing drug-eluting stents to correct CA. However, 2 out of 3 patients in the study required a second operation under general anesthesia. The repeated visits to the operating room for evaluations and debridement under general anesthesia continues to be a concern for increased morbidity and mortality in infants undergoing repair of CA.

Methods

A case series of three (3) patients who underwent repair of CA. Outcomes were measured by post-operative, in-office flexible nasoendoscopy.

Results

Each patient was implanted with mometasone furoate drug-eluting stents at the conclusion of the operation. Post-operatively, patients were instructed to perform nasal saline rinses 3-4 times daily. Outpatient follow-up between 6-17 months showed patent nasal passages on nasal endoscopy. There were no post-operative complications. Moreover, patients only underwent a single episode of general anesthesia at time of initial repair.

Conclusions

In our study, we report successful outcomes using drugeluting stents for one-stage surgical correction of CA, therefore negating the need for children to undergo multiple subjections to general anesthetics.

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