Revision XXXX repair.

@entity1 @entity3145 @entity705 @entity1415 @entity1138 @entity600 @entity16453 @entity2721 @entity850
OBJECTIVE: Since the first description of @entity16453 ( @entity16453 ) in 1755, multiple surgical techniques have been proposed to repair the @entity600 . Today, the transnasal endoscopic method is the most widely accepted repair technique. The bony choanal plates are perforated, the lateral choanae are drilled, and a portion of the vomer removed. Unfortunately, the problem of @entity850 is a significant issue, and as a result, revision surgery may be a recurring theme in some @entity1 . We describe a successful revision endoscopic technique utilizing a microdebrider with straight and 120 degrees telescopes, image guided surgery, and topical @entity1138 -C to permanently open the choanae without stenting. METHODS: Described are six @entity1 (1-15 years old) with @entity16453 or @entity850 who have collectively undergone 25 choanal procedures at various institutions. A microdebrider carefully removes the bony septum under direct nasal and intraoral telescopic visualization. No lateral drilling is performed. Image guidance is helpful when @entity3145 is present. Topical mitomycin-C minimizes post-operative scarring. The @entity705 is left intact. RESULTS: 2-4-year clinical and endoscopic follow-up on all @entity1 revealed a widely patent nasal airway with no complications ( @entity1415 , crusting, or @entity850 ). Synechiae or @entity850 did not occur as circumferential mucosal stripping was avoided. No stenting was needed since the bony septum is removed. CONCLUSION: Near @entity2721 provides long-term nasal patency for revision @entity16453 repairs. The endoscopic 'common choanae' technique is aided by transnasal and transoral telescopic visualization with precise microdebrider removal of the bony septum. The technique is safe with no complications in our case series.
