Abstract
Objectives:
Describe and demonstrate by video the transnasal endoscopic repair of bilateral mixed or bony choanal (BMCA/BBCA) in low-weight newborns using 1.7-mm diameter telescope and a 0.3- to 06-mm diameter fiber-delivered contact diode laser (CDL) at 810-nm wavelength and combined use of Skeeter stapes microdrill.
Methods:
Prospective study at a tertiary-care pediatric institution of 11 neonates with BMCA or BBCA, aged 3 to 11 days, weighing 1.8 kg to 2.5 kg. A transnasal endoscopic approach with contact diode laser and/or combined use of skeeter microdrill was applied in all children. All patients were stented bilaterally from 4 to 13 weeks. Patients were followed by serial weekly clinical examinations, rigid endoscope examination at stents removal and/or revision surgery, with subsequent revision surgery if needed. Second surgical revision was performed in 5 children, while 1 child required a third procedure. Five children required 1 procedure only. Further postoperative endoscopic examinations were scheduled for 3, 6, 12 months, and then an annual endoscopic examination was performed.
Results:
No complication after surgery was encountered, and all children were discharged the second day after surgery. Follow-up time frame ranged from 1 to 10 years. Neither restenosis nor craniofacial growth abnormality was seen.
Conclusions:
BMCA/BBCA was successfully repaired using this narrow endoscopic contact combined microdrill/laser approach, with no complications and a reduced need for revision surgery compared with prior reports. This new surgical technique is demonstrated to treat BMCA/BBCA in small birth weight neonates. Further studies are warranted.
Get full access to this article
View all access options for this article.