TRANSORAL REPAIR OF CHOANAL ATRESIA

摘要

The transoral repair of choanal atresia is a method for the surgical repair of choanal atresia that uses a transoral approach. The procedure includes the use of a curved drill, a curved shaver, curved grasping forceps, and a suction irrigator. After endotracheal intubation, a retractor is inserted to retract the tongue. A 120° angled telescope is inserted behind the soft palate into the nasopharynx to visualize the posterior choanae. A curved drill is used to drill the atretic plate from the vomer medially to the lateral pterygoid plate laterally. The drilled section of the atretic plate is removed to clear the obstruction.

主权项

1. A method for transoral repair of choanal atresia in a human patient, comprising the steps of:
(a) intubating the trachea; (b) inserting a Dingman mouth gag retractor to retract the tongue; (c) inserting a 120° telescope behind the soft palate into the nasopharynx to visualize the posterior choanae; (d) identifying the following surgical landmarks:
(1) the atretic plate;(2) the posterior end of the vomer bone and(3) the torus tubaris; (e) inserting a curved drill transorally into the nasopharynx; (f) drilling the atretic plate from the vomer bone medially (posterior nasal septum) until the lateral pterygoid plate laterally; (g) removing and vacuuming any bone dust and reducing the heat generated by the drill using a suction irrigator in conjunction with the curved drill; (h) removing any soft tissue component of the atresia using a curved shaver; and (i) remove any bony spicules or fractured bony parts of the atretic plate using a curved grasping forceps.