KHẢO SÁT ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG VÀ KẾT QUẢ ĐIỀU TRỊ BỆNH LÝ HẸP CỬA MŨI SAU TẠI BỆNH VIỆN NHI ĐỒNG 1

Abstract

Introduction: Choanal atresia is an uncommon condition, characterized by partial or complete obstruction of the airway from the nasal cavity to the nasopharynx. Choanoplasty is necessary to maintain sufficient upper respiratory ventilation in affected patients. The understanding of the classification of the disease, the types of the atretic plate, and different treatment approaches can considerably enhance the management and prognosis of patients. Methods: Restrospective review of 18 pediatric patients diagnosed with choanal atresia treated at Children’s Hospital 1 from 2018 to 2023. Results: The majority of patients were diagnosed with bilateral choanal atresia, which is 2.6 times higher than unilateral cases. In the bilateral choanal atresia group, neonates make up the highest percentage (46.2%), whereas in the unilateral group, most of the patients are infants and children above two years old. The distribution of gender in two groups was relatively equal. Within the bilateral choanal atresia group, 46.2% had concomitant malformations, which mainly are craniofacial and cardiac anomalies. Respiratory distress was reported in 69.2% of bilateral cases, whereas respiratory distress was not reported in unilateral cases. Initial airway management was not recorded in unilateral cases, while 7.7% of bilateral cases required endotracheal intubation, and 23.1% required both intubation and tracheostomy. In addition, 53.8% of bilateral cases required more than two surgeries, whereas 60% of unilateral cases required only one surgery. In 23.1% of bilateral cases, there were postoperative bleeding problems noted. Conclusion: Bilateral choanal atresia is typically more associated with other malformations, respiratory distress, and recurrence compared to its unilateral counterpart. The primary surgical method at Children's Hospital 1 is transnasal puncture with urethral sounds, and a cutting and suction system, with a low rate of bleeding complications. The rate of restenosis remained relatively high.