Julie E Strychowsky1, Kosuke Kawai1, Ethan Moritz1, Reza Rahbar1,2, Eelam A Adil1,2. 1. Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, Massachusetts. 2. Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, U.S.A.
Abstract
OBJECTIVES: The use of nasal stents as a postoperative adjunct following repair of choanal atresia remains controversial. The study objective was to systematically review the literature regarding the efficacy and safety of stenting following transnasal endoscopic repair of bilateral choanal atresia. STUDY DESIGN: Systematic review with meta-analysis. METHODS: A comprehensive search in PubMed, EMBASE, CINAHL, and the Cochrane Library was conducted. Inclusion criteria included articles written in the English language with five or more subjects and clear intervention data and outcomes. Two independent reviewers screened studies for eligibility, appraised the level of evidence, extracted data, and resolved discrepancies by consensus. Successful surgery was defined as the absence of restenosis. RESULTS: Of 154 identified studies, 15 met inclusion criteria. Levels of evidence varied from level 3 to 4. Mean age at surgery ranged from 5 days to 25 months. Thirteen studies (n = 167 patients) included patients who were stented; the weighted pooled proportion of successful surgery was 65% (95% confidence interval [CI], 49-76%). Mean duration of stenting ranged from 48 hours to 16 weeks. Six studies (n = 42) evaluated patients who were not stented; the weighted pooled proportion of successful surgery was 64% (95% CI, 42-84%). Complications associated with stenting included alar injury, vestibular stenosis, columellar tear, and stent dislodgement or blockage. CONCLUSIONS: Success rates for bilateral choanal atresia repair were similar with and without the use of nasal stents. The use of nasal stents may be associated with more complications. There is insufficient data to determine if mitomycin C is a useful therapeutic adjunct.
OBJECTIVES: The use of nasal stents as a postoperative adjunct following repair of choanal atresia remains controversial. The study objective was to systematically review the literature regarding the efficacy and safety of stenting following transnasal endoscopic repair of bilateral choanal atresia. STUDY DESIGN: Systematic review with meta-analysis. METHODS: A comprehensive search in PubMed, EMBASE, CINAHL, and the Cochrane Library was conducted. Inclusion criteria included articles written in the English language with five or more subjects and clear intervention data and outcomes. Two independent reviewers screened studies for eligibility, appraised the level of evidence, extracted data, and resolved discrepancies by consensus. Successful surgery was defined as the absence of restenosis. RESULTS: Of 154 identified studies, 15 met inclusion criteria. Levels of evidence varied from level 3 to 4. Mean age at surgery ranged from 5 days to 25 months. Thirteen studies (n = 167 patients) included patients who were stented; the weighted pooled proportion of successful surgery was 65% (95% confidence interval [CI], 49-76%). Mean duration of stenting ranged from 48 hours to 16 weeks. Six studies (n = 42) evaluated patients who were not stented; the weighted pooled proportion of successful surgery was 64% (95% CI, 42-84%). Complications associated with stenting included alar injury, vestibular stenosis, columellar tear, and stent dislodgement or blockage. CONCLUSIONS: Success rates for bilateral choanal atresia repair were similar with and without the use of nasal stents. The use of nasal stents may be associated with more complications. There is insufficient data to determine if mitomycin C is a useful therapeutic adjunct.
Authors: R Bovo; P Trevisi; E Zanoletti; D Cazzador; T Volo; E Emanuelli; A Martini Journal: Acta Otorhinolaryngol Ital Date: 2017-10 Impact factor: 2.124
Authors: Salvatore Ferlito; Antonino Maniaci; Alberto Giulio Dragonetti; Salvatore Cocuzza; Jerome Rene Lechien; Christian Calvo-Henríquez; Juan Maza-Solano; Luca Giovanni Locatello; Sebastiano Caruso; Francesco Nocera; Andrea Achena; Niccolò Mevio; Gabriella Mantini; Giorgio Ormellese; Angelo Placentino; Ignazio La Mantia Journal: Int J Environ Res Public Health Date: 2022-07-26 Impact factor: 4.614
Authors: Josee Paradis; Agnieszka Dzioba; Hamdy El-Hakim; Paul Hong; Frederick K Kozak; Lily H P Nguyen; Demitri Perera; Evan Jon Propst; Jennifer M Siu; Monika Wojtera; Murad Husein Journal: J Otolaryngol Head Neck Surg Date: 2021-07-13