Skeeter Microdrill and Contact Laser Choanal Atresia Repair in Very Low Weight Newborns

Video Type: CVideo
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Author: Riccardo D'Eredita'
Published:
Specialties: Endoscopy, Pediatric Surgery
Schools: Vanderbilt University
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Basic Info
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Procedure

Use of 2.7 telescopes, ear instrumentation, contact diode laser, and Skeeter stapes microdrill do open bilateral atretic plate in premies or very low-weight newborns

Indications

Unilateral (uncommon) or bilateral choanal atresia (mixed or osseous in type)

Contraindications

Concurrent medical condition that avoid surgery at day 1-2 of age, very low anterior skull base, no consent from parents

Instrumentation

Setup

stapes surgery table, skeeter, cottonoids, small 0 and 30 deg telescopes

Preoperative Workup

HRCT of head, complete workup to exclude CHARGE condition. If confirmed, adequate preop treatment/measures

Anatomy and Landmarks

middle turbinate, anterior skull base, palate, rhinopharynx, sphenopalatine plate, orientation of atretic plate

Advantages/Disadvantages

anterior endoscopic approach, bloodless, rapid procedure, possibility to avoid stenting, feasible even in 1.8 kgs premies

Complications/Risks

bleeding, restenosis, lesions to skull base

Disclosure of Conflicts

bleeding, restenosis, lesions to skull base

Acknowledgements

nursing and scrub staff at Vicenza Pediatric ENT

References

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