NGHIÊN CỨU ĐẶC ĐIỂM LÂM SÀNG, CHẨN ĐOÁN HÌNH ẢNH TỊT CỬA MŨI SAU BẨM SINH Ở TRẺ EM

Abstract

Objective: To describe the clinical characteristics and imaging diagnosis of congenital choanal atresia in children from 2018 to 2024 at the Vietnam National Children's Hospital. Research Method: A descriptive observational study of a case series involving 20 patients diagnosed and surgically treated for congenital choanal atresia between January 1, 2018, and August 1, 2024, at the Vietnam National Children's Hospital. Results: The male to female ratio was 1:1.5; the rate of full-term births was 85%. Endoscopic examination showed a bilateral atresia to unilateral atresia ratio of 1.5:1; right-sided atresia to left-sided atresia was 37.5%:62.5%. CT imaging revealed mixed membrane and bone atresia in 80%, membrane atresia in 15%, and bone atresia in 5%. The most common functional symptom was frequent nasal obstruction (90%). Bilateral choanal atresia was most commonly associated with frequent nasal obstruction (91.7%) and intermittent feeding (91.7%), while unilateral choanal atresia was most commonly associated with frequent nasal obstruction (87.5%). Patients with associated congenital anomalies accounted for 60%, with cardiac anomalies comprising 30%. Conclusion: The incidence in females is higher than in males; bilateral choanal atresia is more common than unilateral, with left-sided atresia more prevalent than right-sided; mixed membrane-bone atresia is the most common type. The most frequently encountered functional symptom is frequent nasal obstruction. The most common physical signs are methylene blue staining and the inability to pass a catheter through the choana, with no mist observed during laryngoscope examination at the choana. The majority of patients have associated anomalies, with cardiac defects being the most common.