Repair of Choanal Atresia and Oro-Nasal Fistula in One Sitting

2012 ◽  
Vol 49 (2) ◽  
pp. 249-250
Author(s):  
Hussam M. El-Bosraty ◽  
Mosaad M. Abdel-Aziz

A seven month-old girl with bilateral choanal atresia presented to our institution with oro-nasal fistula secondary to a previous atresia repair. Examination revealed obstruction of both choanae and the presence of a fistula located in the hard palate. Endoscopic repair of the atresia and a two-layer closure of the fistula were carried out in one sitting. Follow-up of the patient for 6 months showed patent choanae and a healed palatal fistula.

2021 ◽  
Vol 10 (13) ◽  
pp. 2951
Author(s):  
Maria Baldovin ◽  
Diego Cazzador ◽  
Claudia Zanotti ◽  
Giuliana Frasson ◽  
Athanasios Saratziotis ◽  
...  

Bilateral choanal atresia (CA) is a rare congenital malformation frequently associated with other anomalies. CHARGE association is closely linked to bilateral CA. The aim of this study was to describe the outcomes of the endoscopic repair in bilateral CA, and to assess the role of postoperative nasal stenting in two cohorts of CHARGE-associated and non-syndromic CA. Thirty-nine children were retrospectively analyzed (16 patients had CHARGE-associated CA). The rate of postoperative neochoanal restenosis was 31.3% in the CHARGE population, and 47.8% in the non-syndromic CA cohort. Data on postoperative synechiae and granulation tissue formation, need for endonasal toilette and dilation procedures, and number of procedures per patient were presented. Stent positioning led to a higher number of postoperative dilation procedures per patient in the non-syndromic cohort (p = 0.018), and to a higher rate of restenosis both in the CHARGE-associated, and non-syndromic CA populations. Children with CHARGE-associated and non-syndromic bilateral CA benefitted from endonasal endoscopic CA correction. The postoperative application of an endonasal stent should be carefully evaluated.


2021 ◽  
pp. 105566562110037
Author(s):  
Catherine de Blacam ◽  
David Orr

In response to the article by Rothermel and colleagues, the authors suggest the use of cancellous bone graft for repair of fistulae of the hard palate as an addition to the proposed toolbox.


2019 ◽  
Vol 23 (1) ◽  
pp. 54-60
Author(s):  
Nicholas A. Pickersgill ◽  
Gary B. Skolnick ◽  
Sybill D. Naidoo ◽  
Matthew D. Smyth ◽  
Kamlesh B. Patel

OBJECTIVEMetrics used to quantify preoperative severity and postoperative outcomes for patients with sagittal synostosis include cephalic index (CI), the well-known standard, and the recently described adjusted cephalic index (aCI), which accounts for altered euryon location. This study tracks the time course of these measures following endoscopic repair with orthotic helmet therapy. The authors hypothesize that CI and aCI show significant regression following endoscope-assisted repair.METHODSCT scans or 3D photographs of patients with nonsyndromic sagittal synostosis treated before 6 months of age by endoscope-assisted strip craniectomy and postoperative helmet therapy (n = 41) were reviewed retrospectively at three time points (preoperatively, 0–2 months after helmeting, and > 24 months postoperatively). The CI and aCI were measured at each time point.RESULTSMean CI and aCI increased from 71.8 to 78.2 and 62.7 to 72.4, respectively, during helmet treatment (p < 0.001). At final follow-up, mean CI and aCI had regressed significantly from 78.2 to 76.5 and 72.4 to 69.7, respectively (p < 0.001). The CI regressed in 33 of 41 cases (80%) and aCI in 39 of 41 cases (95%). The authors observed a mean loss of 31% of improvement in aCI achieved through treatment. A strong, positive correlation existed between CI and aCI (R = 0.88).CONCLUSIONSRegression following endoscope-assisted strip craniectomy with postoperative helmet therapy commonly occurs in patients with sagittal synostosis. Future studies are required to determine whether duration of helmet therapy or modifications in helmet design affect regression.


2021 ◽  
Vol 72 (1) ◽  
pp. 51-56
Author(s):  
R. Bartel ◽  
M. Levorato ◽  
M. Adroher ◽  
S. Cardelus ◽  
A. Diaz ◽  
...  

Author(s):  
Orlando Salvalaio Neto ◽  
Stella Cristina Soares Araújo ◽  
Grasiele Do Nascimento Lopes ◽  
Antônio De Melo Cabral ◽  
Zilda Fagundes Oliveira ◽  
...  

2015 ◽  
Vol 3 (7_suppl2) ◽  
pp. 2325967115S0008
Author(s):  
Danyal H. Nawabi ◽  
Catherine Wentzel ◽  
Anil S. Ranawat ◽  
Asheesh Bedi ◽  
Bryan T. Kelly

Author(s):  
Indu Palanivel ◽  

Necrotizing Sialometaplasia is rare and in the oral cavity it accounts <1% of all biopsied lesion. For decades Necrotizing Sialometaplasia were treated by conservative management as it is a self healing lesion. The progressive healing period was reported from 2 weeks to 3 months in the literature. Is necrotizing sialometaplasia a self-limiting disease? Here we report a case of non-healing necrotizing sialometaplasia which was treated by surgical management. Complete regression of the lesion was evident after the surgical management and no recurrence until two years of follow-up.


2021 ◽  
Vol 22 (4) ◽  
pp. 209-213
Author(s):  
Jin Mi Choi ◽  
Hojin Park ◽  
Tae Suk Oh

Primary palatoplasty for cleft palate places patients at high risk for scarring, altered vascularity, and persistent tension. Palatal fistulas are a challenging complication of primary palatoplasty that typically form around the hard palate–soft palate junction. Repairing palatal fistulas, particularly wide fistulas, is extremely difficult because there are not many choices for closure. However, a few techniques are commonly used to close the remaining fistula after primary palatoplasty. Herein, we report the revision of a palatal fistula using a pedicled buccal fat pad and palatal lengthening with a buccinator myomucosal flap and sphincter pharyngoplasty to treat a patient with a wide palatal fistula. Tension-free closure of the palatal fistula was achieved, as well as velopharyngeal insufficiency (VPI) correction. This surgical method enhanced healing, minimized palatal contracture and shortening, and reduced the risk of infection. The palate healed with mucosalization at 2 weeks, and no complications were noted after 4 years of follow-up. Therefore, these flaps should be considered as an option for closure of large oronasal fistulas and VPI correction in young patients with wide palatal defects and VPI.


2001 ◽  
Vol 15 (5) ◽  
pp. 333-342 ◽  
Author(s):  
Paolo Castelnuovo ◽  
Silvia Mauri ◽  
Davide Locatelli ◽  
Enzo Emanuelli ◽  
Giovanni Delù ◽  
...  

Endoscopic repair of cerebrospinal fluid (CSF) rhinorrhea is becoming a common procedure. The purpose of this study was to perform a literature analysis centering cases of treatment failure and to review our 31 cases with a 1-year minimum follow-up. An extensive search of the literature was conducted, which focused on success rate, follow-up, diagnostic techniques, graft material used, failure rate, and comments on failures. A retrospective analysis of our 31 patients was carried out, and all cases were treated with the endoscopic approach with a 1-year minimum follow-up. From the literature analysis, the median success rate at the first endoscopic attempt is 90%. Our success rate was 87.1%. Failures were analyzed. A unique protocol for CSF leak diagnosis does not exist; we suggest our diagnostic algorithm. Graft material used depends on the authors’ experience, and based on this review of cases to date, did not significantly influence the success rate. The analysis of cases of failure shows that the majority of authors omit details. More research is needed to improve prevention of failures.


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