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Choanal atresia & Nasal stenosis Mrs Ann-Louise McDermott - Consultant Paediatric Otolaryngologist, Birmingham Women’s and Children Hospital National Paediatric Rhinology Training Day, 22nd May 2020 Curriculum topics (UK Otolaryngology Higher Surgical Training 2017) 1. Paediatric otolaryngology - Airway pathology in childhood; ENT related syndromes and cleft palate; Aetiology and management of congenital abnormalities of the head and neck affecting adults (including branchial & thyroglossal cysts, pharyngeal diverticulae, cleft lip & palate); Nasal obstruction 01:02 - Embryology, epidemiology and syndromic associations 03:32 - Pathophysiology 04:20 - Signs and symptoms 05:48 - Bilateral - immediate management 07:27 - Imaging 08:57 - Bilateral - surgical treatment options 11:05 - Unilateral - treatment options 11:43 - Surgery (with video) 15:15 - Stenting and Mitomycin C 16:44 - Pitfalls - submucous cleft and asymmetry of the skull base 19:57 - Complications 20:59 - Consenting and top tips 22:56 - Congenital pyriform aperture stenosis (CPAS) 23:37 - CPAS symptoms and diagnosis; medical and surgical management 26:32 - Midnasal stenosis and management 27:57 - Use of nasal steroids Questions 28:56 - Septal or lateral wall flaps to prevent re-stenosis 29:41 - Removing ’V’ from the septum 30:41 - CT criteria for CPAS 30:56 - Nasal steroids and dose 31:22 - Age of operating if tracheostomy 31:56 - Nasal stenosis patients 32:48 - Repeating balloon dilatations 34:01 - Age and use of flixonase nebules
