Endoscopic management of congenital bilateral posterior choanal atresia: value of using stents

Objective of this study is to evaluate the efficacy and safety of using stents after endoscopic repair of bilateral posterior choanal atresia. Twenty cases of congenital bilateral posterior choanal atresia were managed by endoscopic transnasal approach which was performed using a nasal stent in 10 cases and without stenting in the other 10 cases. The stent was left for 4 weeks and patients had 1–5 years of follow-up. Patients have been evaluated subjectively and objectively: clinical and by endoscopic examination. Closure occurs in 20% of the stent group compared to 30% of the non-stent group, with no statistically significant difference between the two groups. On the other hand, choanal narrowing and stenosis occurs in 40% of the stent group compared to 20% of the non-stent group with a statistically significant difference between the two groups. Granulation tissue formation was detected in 50%, erosion of the nares in 10%, premature extrusion in 10%, and dislodgement in 10% of stent group. Granulation tissue formation was detected in 20%, hemorrhage occurred in 10% of the non-stent group patients. There was a statistically significant difference between the two groups (P-value  < 0.05) regarding granulation tissue formation. The use of stents after endoscopic repair of congenital bilateral posterior choanal atresia does not seem to decrease the incidence of re-closure and restenosis of the posterior choana. On the other hand, there are higher complication rate from using the stents like granulation tissue formation, excoriation or erosion of the nares, premature extrusion, dislodgement, stent blockage, and the unsightly aspect of having stents protrude from the nose.