Surgical management of choanal atresia: improved outcome using mitomycin.
نویسندگان
چکیده
OBJECTIVE To evaluate the intraoperative use of mitomycin to improve the surgical outcome and reduce the rate of soft tissue restenosis in children undergoing choanal atresia repair. DESIGN Retrospective chart review of all patients surgically treated for congenital choanal atresia by the senior author (W.F.M). SETTING Tertiary children's hospital. PATIENTS Eight consecutive patients with bony choanal atresia (6 unilateral and 2 bilateral) were compared with 15 historical controls (6 unilateral and 9 bilateral). All study and historical control patients were treated with soft plastic postoperative stenting. INTERVENTION At the completion of the surgical repair of the choanal atresia, 0.4 mg/mL of topical mitomycin was applied to the posterior choanae for 3 minutes. MAIN OUTCOME MEASURE The success rate of the repair of the choanal atresia as determined by the postoperative need for dilation or revision surgical procedures was compared with that of the historical controls. RESULTS All 8 children with intraoperative use of mitomycin were treated with a mean +/- SEM of 0.375 +/- 0.183 dilations per patient. The 15 children in the control group received a mean +/- SEM of 3.667 +/- 0.583 postoperative dilations for soft tissue restenosis. The difference in the number of postoperative dilations between the study and control group was statistically significant (P =.006) using a t test. CONCLUSIONS Mitomycin is an effective and reliable treatment for improving the surgical outcome for choanal atresia repair. This may obviate the need for postoperative dilations and may potentially eliminate the need for surgical stenting.
منابع مشابه
Topical mitomycin as an adjunct to choanal atresia repair.
OBJECTIVE To evaluate the use of topical mitomycin in choanal atresia repair to reduce the development of granulation tissue and cicatrix. DESIGN AND SETTING Retrospective case series in 2 tertiary care centers. PATIENTS Twenty patients with either unilateral or bilateral congenital choanal atresia underwent repair using the transnasal endoscopic approach, the transpalatal approach, or both...
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ورودعنوان ژورنال:
- Archives of otolaryngology--head & neck surgery
دوره 127 11 شماره
صفحات -
تاریخ انتشار 2001