Melissa S Oh1, Nadja Kadom2, Shelly Abramowicz3, Norman Wendell Todd4. 1. Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, Atlanta, GA, United States of America. 2. Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, United States of America; Department of Radiology, Children's Healthcare of Atlanta, Atlanta, GA, United States of America. 3. Division of Oral and Maxillofacial Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, GA, United States of America; Section Chief of Oral and Maxillofacial Surgery, Children's Healthcare of Atlanta, Atlanta, GA, United States of America. 4. Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, Atlanta, GA, United States of America. Electronic address: ntodd@emory.edu.
Abstract
PURPOSE: We hypothesized that the ontogeny of unilateral isolated choanal atresia involves a field defect manifesting as ipsilateral mandibular condylar hypoplasia. The topic is important because the mechanism of the unilateral isolated choanal atresia is unknown. MATERIALS AND METHODS: Retrospective self-controlled case series. We included 20 patients (2 males and 18 females, ages 2 weeks to 13 years) with unilateral isolated non-syndromic choanal atresia. We studied their high-resolution computed tomographic scans. Two otolaryngologists measured the largest cross-sectional area of the mandibular condyle in the axial plane perpendicular to the posterior border of each mandibular ramus independently. Statistical significance and inter-rater agreement were calculated with paired Wilcoxon rank sum test and Spearman's non-parametric correlation coefficient respectively. RESULTS: Cross-sectional areas of the condyles ipsilateral to the choanal atresia were not statistically different than those of the contralateral condyle (P = 0.27). Inter-observer agreement of condyle areas was excellent: Spearman's r = 0.85 on the right and r = 0.94 on the left. CONCLUSIONS: In this cohort of children with the rarity of isolated non-syndromic unilateral congenital choanal atresia, no associated mandibular condyle hypoplasia was found. The data suggest that the underlying ontogeny was unlikely attributable to a field defect.
PURPOSE: We hypothesized that the ontogeny of unilateral isolated choanal atresia involves a field defect manifesting as ipsilateral mandibular condylar hypoplasia. The topic is important because the mechanism of the unilateral isolated choanal atresia is unknown. MATERIALS AND METHODS: Retrospective self-controlled case series. We included 20 patients (2 males and 18 females, ages 2 weeks to 13 years) with unilateral isolated non-syndromic choanal atresia. We studied their high-resolution computed tomographic scans. Two otolaryngologists measured the largest cross-sectional area of the mandibular condyle in the axial plane perpendicular to the posterior border of each mandibular ramus independently. Statistical significance and inter-rater agreement were calculated with paired Wilcoxon rank sum test and Spearman's non-parametric correlation coefficient respectively. RESULTS: Cross-sectional areas of the condyles ipsilateral to the choanal atresia were not statistically different than those of the contralateral condyle (P = 0.27). Inter-observer agreement of condyle areas was excellent: Spearman's r = 0.85 on the right and r = 0.94 on the left. CONCLUSIONS: In this cohort of children with the rarity of isolated non-syndromic unilateral congenital choanal atresia, no associated mandibular condyle hypoplasia was found. The data suggest that the underlying ontogeny was unlikely attributable to a field defect.
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