Reducing the need for general anesthesia in the repair of choanal atresia with steroid-eluting stents: A case series.

Affiliation

Department of Otolaryngology - Head and Neck Surgery, The Cleveland Clinic, Cleveland, OH, United States. Electronic address: [Email]

Abstract

BACKGROUND : 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 and 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.

Keywords

Choanal atresia,Congenital anomalies,Drug-eluting stent,Pediatric anesthesia,

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