{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T03:20:49Z","timestamp":1792207249595,"version":"4.4.0"},"reference-count":24,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2016,7,19]],"date-time":"2016-07-19T00:00:00Z","timestamp":1468886400000},"content-version":"vor","delay-in-days":5527,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2001,6]]},"abstract":"<jats:sec><jats:title>PURPOSE:<\/jats:title><jats:p>To describe improved surgical treatment for posterior choanal atresia (PCA) by creating mucosal flaps with the aid of operating microscope, CO<jats:sub>2<\/jats:sub> laser, self\u2010retaining nasal retractor, and stenting with a flat polytetrafluoroethylene (Teflon) keel.<\/jats:p><\/jats:sec><jats:sec><jats:title>MATERIALS AND METHODS:<\/jats:title><jats:p>Retrospective study of 19 patients with PCA, their ages ranging from 6\u00a0days to 4 years 4\u00a0months at the time of first repair, representing a total of 32\u00a0PCA repairs. Four patients had unilateral PCA, and one did not return for follow\u2010up and could not be located. A transnasal microscopic approach uses a myringotomy knife or CO<jats:sub>2<\/jats:sub> laser to create an anterior mucosal flap; the CO<jats:sub>2<\/jats:sub> laser is also used to remove any bone plate and to create the posterior flap. The flaps then are rotated into position and are kept separated by a flat Teflon keel instead of a traditional round stent to avoid pressure necrosis. When a stable epithelialized opening (2 \u00d7 2 to 3 \u00d7 4\u00a0mm) is created, it is enlarged by subsequent staged transnasal CO<jats:sub>2<\/jats:sub> laser submucosal scar excisions with preservation of the overlying mucosa. This creates rotation or sliding flaps to speed healing and prevents circumferential scar contraction.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS:<\/jats:title><jats:p>Eighteen patients were re\u2010examined after periods of 3\u00a0months to more than 5 years from when their first epithelialized orifice was created with nasal endoscopy to measure the final orifice size. All 18 patients had clinically adequate\u2010to\u2010good bilateral nasal airways at the latest follow\u2010up with an average orifice size of 3 \u00d7 5\u00a0mm and a range of 2 \u00d7 2 to 4 \u00d7 10\u00a0mm. This \u201csame day surgery\u201d technique with staged procedures provides similar or better patency rates than a single transpalatal approach but with less surgical morbidity. It has a much lower restenosis rate than the transnasal puncture or PCA excision with prolonged round tube stenting and multiple dilation technique.<\/jats:p><\/jats:sec>","DOI":"10.1177\/019459980112400615","type":"journal-article","created":{"date-parts":[[2017,7,13]],"date-time":"2017-07-13T14:56:24Z","timestamp":1499957784000},"page":"674-682","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Transnasal Mucosal Flap Rotation Technique for Repair of Posterior Choanal Atresia"],"prefix":"10.1002","volume":"124","author":[{"given":"Herbert H.","family":"Dedo","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery University of California San Francisco California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,7,19]]},"reference":[{"key":"e_1_2_1_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-5876(86)80010-6"},{"key":"e_1_2_1_3_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215100045965"},{"key":"e_1_2_1_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1959.00730040005001"},{"key":"e_1_2_1_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1961.00740020641001"},{"key":"e_1_2_1_6_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215100074235"},{"key":"e_1_2_1_7_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-198404000-00001"},{"key":"e_1_2_1_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-198984040-00019"},{"key":"e_1_2_1_9_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-199010000-00020"},{"key":"e_1_2_1_10_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215100112939"},{"key":"e_1_2_1_11_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-197708000-00010"},{"key":"e_1_2_1_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348948909800205"},{"key":"e_1_2_1_13_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-197604000-00008"},{"key":"e_1_2_1_14_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-198711000-00005"},{"key":"e_1_2_1_15_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-197308000-00011"},{"key":"e_1_2_1_16_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-195003000-00004"},{"key":"e_1_2_1_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348947908800404"},{"key":"e_1_2_1_18_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-198906000-00001"},{"key":"e_1_2_1_19_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-198208000-00012"},{"key":"e_1_2_1_20_1","first-page":"389","volume-title":"Current therapy in otolaryngology head and neck surgery","author":"Munz HR","year":"1998"},{"key":"e_1_2_1_21_1","doi-asserted-by":"publisher","DOI":"10.1177\/019459989010300608"},{"key":"e_1_2_1_22_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215100120055"},{"key":"e_1_2_1_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.5541040521"},{"key":"e_1_2_1_24_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215100129172"},{"key":"e_1_2_1_25_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348947808700510"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/019459980112400615","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/019459980112400615","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T10:36:57Z","timestamp":1760956617000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1177\/019459980112400615"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2001,6]]},"references-count":24,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2001,6]]}},"alternative-id":["10.1177\/019459980112400615"],"URL":"https:\/\/doi.org\/10.1177\/019459980112400615","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"value":"0194-5998","type":"print"},{"value":"1097-6817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2001,6]]},"assertion":[{"value":"2016-07-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}