{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T08:32:54Z","timestamp":1740126774903,"version":"3.37.3"},"reference-count":44,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Laryngorhinootologie"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>Die Choanalatresie (CA) ist eine seltene kongenitale Anomalie der nasalen Atemwege mit einer Inzidenz von 1\/5000 bis 1\/9000, die unilateral (uCA) oder bilateral (bCA) auftreten kann. Die bCA manifestiert sich als akuter Notfall unmittelbar nach der Entbindung durch akute Atemwegsobstruktion und paradoxe Zyanose, w\u00e4hrend die uCA neben der einseitigen Nasenatmungsbehinderung ein klinisch heterogenes Beschwerdebild aufweisen kann. Die fiberendoskopische Untersuchung ist in Verbindung mit der kranialen Computertomographie der Goldstandard in der diagnostischen Abkl\u00e4rung der CA. Die CA tritt h\u00e4ufig in Assoziation zu angeborenen Fehlbildungssyndromen auf, unter denen das CHARGE-Syndrom hervorzuheben ist. Aufgrund von kardiopulmonaler Instabilit\u00e4t und erschwerten Intubationsbedingungen sind syndromale CA-PatientInnen als eigene Risikogruppe aufzufassen. Nach Sicherung des Atemweges muss die bCA zeitnah operativ versorgt werden, w\u00e4hrend die Korrektur der uCA erst nach dem sechsten Lebensmonat erfolgen sollte. Die endoskopischen Operationstechniken sind der chirurgische Standard in der Versorgung der CA. Hierbei lassen sich unterschiedliche Herangehensweisen differenzieren: die transnasale Punktion der Atresieplatte mit anschlie\u00dfender Erweiterung nach medial und lateral, die Anlage eines Septumfensters mit anschlie\u00dfender posteriorer Vomer- und Atresieplattenresektion und die Anlage mukoperiostealer Lappen mit anschlie\u00dfender Er\u00f6ffnung der Atresieplatte. Der transpalatinale Zugangsweg sollte nur noch in anatomisch komplexen Ausnahmef\u00e4llen gew\u00e4hlt werden. Der Einsatz konventioneller choanaler Stents in der prim\u00e4ren Versorgung der CA wird zunehmend zur\u00fcckgewiesen und sollte Risikokonstellationen vorbehalten bleiben. Ebenso sollte auf die lokale Applikation von Mitomycin C verzichtet werden.<\/jats:p>","DOI":"10.1055\/a-2160-2777","type":"journal-article","created":{"date-parts":[[2023,9,19]],"date-time":"2023-09-19T22:53:26Z","timestamp":1695164006000},"page":"25-34","source":"Crossref","is-referenced-by-count":0,"title":["Klinisches Management der Choanalatresie"],"prefix":"10.1055","volume":"103","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8513-7572","authenticated-orcid":false,"given":"Alexander Philippe","family":"Maas","sequence":"additional","affiliation":[{"name":"Klinik und Poliklinik f\u00fcr Hals-Nasen-Ohren-Heilkunde, Universit\u00e4tsklinikum Bonn, Bonn, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sebastian","family":"Strieth","sequence":"additional","affiliation":[{"name":"Klinik und Poliklinik f\u00fcr Hals-Nasen-Ohren-Heilkunde, Universit\u00e4tsklinikum Bonn, Bonn, 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