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Monatsschrift Kinderheilkunde

, Volume 167, Issue 3, pp 257–266 | Cite as

Choanalatresie

Symptome, Diagnose und Therapie
  • Olaf SommerburgEmail author
  • Peter Amrhein
  • Peter K. Plinkert
  • Assen Koitschev
  • Ingo Baumann
CME
  • 506 Downloads

Zusammenfassung

Die Choanalatresie (CA) tritt selten auf. Neugeborene mit beidseitiger CA benötigen nach der Geburt die schnelle Intubation und Beatmung sowie die baldige chirurgische Rekanalisation. Die einseitige CA führt kaum und häufig erst später zu respiratorischen Beschwerden und wird erst dann korrigiert. Initial erfolgen Sondierung und Inspektion mit einem flexiblen, dünnen Endoskop. Endgültige Diagnosestellung, Operationsplanung und Ausschluss weiterer Fehlbildungen der Schädelbasis erfordern tomographische Untersuchungen. Chirurgische Behandlungen fokussieren die transnasale Endoskopie. Wichtig ist, dass im Rahmen der Operation die in die Atresie einbezogenen Anteile des Vomers mitreseziert werden. Postoperativ wird mithilfe kortikosteroidhaltiger Nasensprays und kochsalzhaltiger Nasenspülungen über mehrere Wochen behandelt. Die Rarität der Diagnose verhindert prospektive randomisierte und kontrollierte Studien, die eine valide Aussage über die zu bevorzugende Operationstechnik erlauben.

Schlüsselwörter

Kranofaziale Fehlbildung CHARGE Assoziation Vomerresektion Endoskopische OP-Technik Restenose 

Choanal atresia

Symptoms, diagnosis and treatment

Abstract

Choanal atresia (CA) is a rare malformation. Newborns with bilateral CA require rapid intubation and ventilation after birth as well as surgical recanalization as soon as possible. Unilateral CA leads to practically no respiratory complaints, becomes symptomatic later and therefore needs no immediate correction. Initial diagnostic exploration should be performed using a thin flexible endoscope. For final diagnosis surgical planning and exclusion of further craniofacial malformations, computed tomographic imaging is required. Surgical treatment currently focuses on transnasal endoscopy. For the success of surgery it is important to resect those parts of the vomer that are included in the atresia. The postoperative treatment includes the use of nasal sprays containing corticosteroids and nasal saline rinsing for several weeks. The rarity of the diagnosis impedes prospective randomized controlled studies, which enable a valid statement on the preferable surgical technique.

Keywords

Craniofacial malformation CHARGE Association Resection of vomer Endoscopic surgical technique Restenosis 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

O. Sommerburg, P. Amrhein, P.K. Plinkert, A. Koitschev und I. Baumann geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2019

Authors and Affiliations

  • Olaf Sommerburg
    • 1
    Email author
  • Peter Amrhein
    • 2
  • Peter K. Plinkert
    • 3
  • Assen Koitschev
    • 2
  • Ingo Baumann
    • 3
  1. 1.Sektion für Pädiatrische Pneumologie & Allergologie und Mukoviszidosezentrum, Zentrum für Kinder- und Jugendmedizin, Klinik IIIUniversitätsklinikum HeidelbergHeidelbergDeutschland
  2. 2.Klinik für Hals‑, Nasen‑, Ohrenkrankheiten, Plastische OperationenKlinikum StuttgartStuttgartDeutschland
  3. 3.Hals-Nasen- und OhrenklinikUniversitätsklinikum HeidelbergHeidelbergDeutschland

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