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Endoscopic Endonasal Repair of Congenital Choanal Atresia: Predictive Factors of Surgical Stability and Healing Outcomes

Background: To assess the long-term outcomes and independent predictors of surgical success of a one-stage minimally invasive surgical procedure for congenital choanal atresia (C.C.A.). Methods: a retrospective multicentric study was conducted between 2010 and 2022. An endonasal endoscopic approach...

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Autores principales: Ferlito, Salvatore, Maniaci, Antonino, Dragonetti, Alberto Giulio, Cocuzza, Salvatore, Lechien, Jerome Rene, Calvo-Henríquez, Christian, Maza-Solano, Juan, Locatello, Luca Giovanni, Caruso, Sebastiano, Nocera, Francesco, Achena, Andrea, Mevio, Niccolò, Mantini, Gabriella, Ormellese, Giorgio, Placentino, Angelo, La Mantia, Ignazio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9329715/
https://www.ncbi.nlm.nih.gov/pubmed/35897454
http://dx.doi.org/10.3390/ijerph19159084
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author Ferlito, Salvatore
Maniaci, Antonino
Dragonetti, Alberto Giulio
Cocuzza, Salvatore
Lechien, Jerome Rene
Calvo-Henríquez, Christian
Maza-Solano, Juan
Locatello, Luca Giovanni
Caruso, Sebastiano
Nocera, Francesco
Achena, Andrea
Mevio, Niccolò
Mantini, Gabriella
Ormellese, Giorgio
Placentino, Angelo
La Mantia, Ignazio
author_facet Ferlito, Salvatore
Maniaci, Antonino
Dragonetti, Alberto Giulio
Cocuzza, Salvatore
Lechien, Jerome Rene
Calvo-Henríquez, Christian
Maza-Solano, Juan
Locatello, Luca Giovanni
Caruso, Sebastiano
Nocera, Francesco
Achena, Andrea
Mevio, Niccolò
Mantini, Gabriella
Ormellese, Giorgio
Placentino, Angelo
La Mantia, Ignazio
author_sort Ferlito, Salvatore
collection PubMed
description Background: To assess the long-term outcomes and independent predictors of surgical success of a one-stage minimally invasive surgical procedure for congenital choanal atresia (C.C.A.). Methods: a retrospective multicentric study was conducted between 2010 and 2022. An endonasal endoscopic approach was performed in 38 unilateral or bilateral C.C.A. children. All the patients were clinically and radiologically assessed and followed for at least 2 years. Seven outcome measures were applied. Consequently, surgical success was correlated with all the independent variables reported. Results: 18/38 (47.36%) patients presented normal postoperative healing, 8/38 (21.05) had moderate restenosis (<50%), while 12/38 (31.57%) cases were severe (>50%), requiring a surgical revision. No statistical significance was found for average hospital stay between stenosis >50% and <50% patients (p = 0.802) and postoperative pain (p = 0.075); instead, the severe restenosis group demonstrated a higher delay of breast suction (p < 0.001). Among the independent variables predictors of surgical success, the presence of Charge syndrome and rhinopharyngeal stenosis demonstrated higher risks for surgical revision (OR: 4.00, 95% CI: 0.57–28.01, and OR: 2.75, 95% CI: 0.55–13.69, respectively). On the contrary, the hypoplastic inferior turbinate and bilateral C.C.A. showed a lower risk for severe restenosis by a higher endoscopic surgical space and creating a single larger opening (OR: 0.88, 95% CI: 0.22–3.52, and OR: 0.45, 95% CI: 0.10–2.08). Conclusion: Several independent variables could influence the surgical success after C.C.A. endoscopic repair; however, more high-quality evidence is needed to generate an effective predictive model.
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spelling pubmed-93297152022-07-29 Endoscopic Endonasal Repair of Congenital Choanal Atresia: Predictive Factors of Surgical Stability and Healing Outcomes Ferlito, Salvatore Maniaci, Antonino Dragonetti, Alberto Giulio Cocuzza, Salvatore Lechien, Jerome Rene Calvo-Henríquez, Christian Maza-Solano, Juan Locatello, Luca Giovanni Caruso, Sebastiano Nocera, Francesco Achena, Andrea Mevio, Niccolò Mantini, Gabriella Ormellese, Giorgio Placentino, Angelo La Mantia, Ignazio Int J Environ Res Public Health Article Background: To assess the long-term outcomes and independent predictors of surgical success of a one-stage minimally invasive surgical procedure for congenital choanal atresia (C.C.A.). Methods: a retrospective multicentric study was conducted between 2010 and 2022. An endonasal endoscopic approach was performed in 38 unilateral or bilateral C.C.A. children. All the patients were clinically and radiologically assessed and followed for at least 2 years. Seven outcome measures were applied. Consequently, surgical success was correlated with all the independent variables reported. Results: 18/38 (47.36%) patients presented normal postoperative healing, 8/38 (21.05) had moderate restenosis (<50%), while 12/38 (31.57%) cases were severe (>50%), requiring a surgical revision. No statistical significance was found for average hospital stay between stenosis >50% and <50% patients (p = 0.802) and postoperative pain (p = 0.075); instead, the severe restenosis group demonstrated a higher delay of breast suction (p < 0.001). Among the independent variables predictors of surgical success, the presence of Charge syndrome and rhinopharyngeal stenosis demonstrated higher risks for surgical revision (OR: 4.00, 95% CI: 0.57–28.01, and OR: 2.75, 95% CI: 0.55–13.69, respectively). On the contrary, the hypoplastic inferior turbinate and bilateral C.C.A. showed a lower risk for severe restenosis by a higher endoscopic surgical space and creating a single larger opening (OR: 0.88, 95% CI: 0.22–3.52, and OR: 0.45, 95% CI: 0.10–2.08). Conclusion: Several independent variables could influence the surgical success after C.C.A. endoscopic repair; however, more high-quality evidence is needed to generate an effective predictive model. MDPI 2022-07-26 /pmc/articles/PMC9329715/ /pubmed/35897454 http://dx.doi.org/10.3390/ijerph19159084 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Ferlito, Salvatore
Maniaci, Antonino
Dragonetti, Alberto Giulio
Cocuzza, Salvatore
Lechien, Jerome Rene
Calvo-Henríquez, Christian
Maza-Solano, Juan
Locatello, Luca Giovanni
Caruso, Sebastiano
Nocera, Francesco
Achena, Andrea
Mevio, Niccolò
Mantini, Gabriella
Ormellese, Giorgio
Placentino, Angelo
La Mantia, Ignazio
Endoscopic Endonasal Repair of Congenital Choanal Atresia: Predictive Factors of Surgical Stability and Healing Outcomes
title Endoscopic Endonasal Repair of Congenital Choanal Atresia: Predictive Factors of Surgical Stability and Healing Outcomes
title_full Endoscopic Endonasal Repair of Congenital Choanal Atresia: Predictive Factors of Surgical Stability and Healing Outcomes
title_fullStr Endoscopic Endonasal Repair of Congenital Choanal Atresia: Predictive Factors of Surgical Stability and Healing Outcomes
title_full_unstemmed Endoscopic Endonasal Repair of Congenital Choanal Atresia: Predictive Factors of Surgical Stability and Healing Outcomes
title_short Endoscopic Endonasal Repair of Congenital Choanal Atresia: Predictive Factors of Surgical Stability and Healing Outcomes
title_sort endoscopic endonasal repair of congenital choanal atresia: predictive factors of surgical stability and healing outcomes
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9329715/
https://www.ncbi.nlm.nih.gov/pubmed/35897454
http://dx.doi.org/10.3390/ijerph19159084
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