Atria repair.pdf

FLSEVIFR SCIEN(‘f International Journal of Pediatric Otorhinolaryngology IRF L -\hl 29 (1994) 51-58 Gastroesophageal reflux complicating choanal atresia repair David J. Beste*a, Stephen F. Conley”, Christopher W. Brownb UDepnrtment of Otolaryngology and Human Communicution, hDepartment oj Pediatrics. Medical College of Wisconsin. Milwaukee, WI, USA (Received 16 October 1992; revision received 27 July 1993: accepted 5 August 1993) Abstract Four infants with bilateral congenital choanal atresia (CCA) underwent transpalatal (3) or transnasal (1) repairs. Postoperatively all four infants experienced gastroesophageal reflux (GER) with intermittent nasal reflux. GER was documented by GER radionuclide scanning in one patient and by dual nasopharyngeal and esophageal pH probe studies in the remaining three patients. The infants with documented GER required prolonged stenting and dilations for choanal restenosis and granulations. The literature emphasizes the importance of the tech- nical repair for prevention of these complications; GER can be a significant complicating factor. Key words; Gastroesophageal reflux; Choanal atresia repair; Complications 1. Introduction Techniques of surgical repair of congenital choanal atresia (CCA) are well describ- ed in the medical literature. Pirsig, in his recent review, states that comparisons are difficult to make regarding the results of transnasal, transseptal and transpalatal ap- proaches 1171. Most reports describing the surgical approaches contain only a small series which fail to delineate important preoperative variables such as syndromic and * Corresponding author, Dept of Otolaryngology, MACC Fund Research Center, 8701 W. Watertown PIank Rd., Milwaukee, WI 53226, USA. Presented at the 6th annual meeting of the American Society of Pediatric Otolaryngology in Waikoloa, Hawaii on May 9-l 1, 1992 0165-5876/94/$07.00 0 I994 Elsevier Science Ireland Ltd. All rights reserved. SSDI 0165-5876(93)00979-O 52