Long-term Quality of Life After Endoscopic Repair of Choanal Atresia in Children

Abstract

Introduction

Children with choanal atresia (CA) typically present with nasal obstruction and require surgical intervention to establish a patent airway. Transnasal endoscopic surgery is the preferred treatment approach. However, long-term outcome data are lacking. This study aims to assess the long-term outcomes and quality of life (QoL) after endoscopic repair of CA.

Methods

Children under age 18 years underwent endoscopic repair of CA using mucoperichondrial flaps developed from the nasal septum between 2007 and 2022. Their parents completed two standardized telephonic QoL questionnaires (Hebrew version, Sino-Nasal 5 (SN-5H) and Nasal Obstruction Symptom Evaluation (He-NOSE)).

Results

The cohort consisted of 40 children, 60% female. Eight had syndromic disease; seven were born prematurely. Mean age at surgery was 25 days for bilateral atresia (65% of patients) and 3.8 years for unilateral atresia. Ten children, most with unilateral CA, needed revision surgery. The mean duration of follow-up was 3.1 years. At the last follow-up, 84.6% of the children had normal choanae, and the remainder had narrowed choanae. Mean time from last follow-up to the parental interview was 5.2 years. SN-5H and He-NOSE scores were similar to those of historical healthy subjects: 1.95 versus 1.76 (P = 0 .4) and 22.3 versus 14.9 (P = 0.08), respectively. Children born prematurely had a higher rate of sinus infections (P = 0 .01) and nasal congestion (P = 0 .05) than children born at term.

Conclusions

Long-term follow-up of children who underwent endoscopic repair of CA using mucoperichondrial flaps showed a stable patent nasal passage with normal QoL for both unilateral and bilateral disease.