The efficacy of mitomycin and stenting in choanal atresia repair: a 20 year experience

Carter, John M., Lawlor, Claire and Guarisco, J. Lindhe (2014) The efficacy of mitomycin and stenting in choanal atresia repair: a 20 year experience. International Journal of Pediatric Otorhinolaryngology, 78 2: 307-311. doi:10.1016/j.ijporl.2013.11.031


Author Carter, John M.
Lawlor, Claire
Guarisco, J. Lindhe
Title The efficacy of mitomycin and stenting in choanal atresia repair: a 20 year experience
Journal name International Journal of Pediatric Otorhinolaryngology   Check publisher's open access policy
ISSN 0165-5876
1872-8464
Publication date 2014-02
Year available 2013
Sub-type Article (original research)
DOI 10.1016/j.ijporl.2013.11.031
Open Access Status
Volume 78
Issue 2
Start page 307
End page 311
Total pages 5
Place of publication London, United Kingdom
Publisher Elsevier
Collection year 2015
Language eng
Formatted abstract
Objective: To determine the efficacy of topical mitomycin and stenting in patients that have undergone endoscopic repair of choanal atresia.

Methods: Retrospective review of 37 endoscopic operations on pediatric patients for choanal atresia.

Results: Twenty-six sides were operated on in 17 patients; 37 total operations were performed. All 17 patients were repaired endoscopically with 1 patient requiring transpalatal revision surgery. Eight patients (47%) had a unilateral atresia and 9 (53%) were bilateral. Eleven total sides (42%) were treated initially with mitomycin. Eighteen percent of those sides required post-operative dilation vs. 40% of the sides not treated with mitomycin (p=0.39) and no patient in the mitomycin group required revision surgery compared to 20% of patients not treated with mitomycin (p=0.24). Significantly fewer sides in the mitomycin group (9%) developed granulation vs. those treated without (53%) (p=0.03). The average number of procedures performed (1.18 vs. 2.53; p=0.002) was significantly fewer in those patients treated with mitomycin vs. not. A greater amount of sides in the stent group developed granulation tissue (50% vs.0%; p=0.023). The average number of procedures performed was significantly greater in those patients treated with a stent (2.33 vs. 1.12; p=0.008). The average time spent in the hospital was significantly shorter (7.09 vs. 2.33 days; p=0.02) in those patients treated without stenting.

Conclusion: Topical mitomycin is efficacious as an adjuvant therapy as it was associated with the formation of less granulation tissue, a lower rate of restenosis and fewer surgeries. Stenting was associated with significantly more procedures, greater formation of granulation tissue and longer overall hospital stays. However, consideration should be given toward stent placement in all neonates for the prevention of post-operative airway obstruction.Level of evidence: 2c.
Keyword Choanal atresia
Dilation
Mitomycin
Stent
Surgery
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Non HERDC
School of Medicine Publications
 
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Created: Mon, 14 Apr 2014, 10:19:56 EST by Matthew Lamb on behalf of School of Medicine