{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T16:39:07Z","timestamp":1788107947512,"version":"build-2803163510"},"reference-count":27,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,8,28]],"date-time":"2018-08-28T00:00:00Z","timestamp":1535414400000},"content-version":"vor","delay-in-days":0,"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":[[2018,11]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To identify risk factors and determine the perioperative morbidity of infants undergoing congenital choanal atresia (CCA) repair.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective analysis of the ACS\u2010NSQIP\u2010P database (American College of Surgeons National Surgical Quality Improvement\u2013Pediatric).<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Tertiary medical center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects and Methods<\/jats:title><jats:p>Patients who underwent CCA repair at age \u2264365\u00a0days at the time of surgery were queried via the ACS\u2010NSQIP\u2010P database (2013\u20102016) via <jats:italic>Current Procedural Terminology<\/jats:italic> code 30540. Analyzed outcomes include age, length of stay, medical comorbidities, operative time, readmission, reoperation, and postoperative complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 168 patients were identified, 70 of which were within the neonatal period. Preoperatively, gastrointestinal disease (<jats:italic>P<\/jats:italic> &lt;. 0001), mechanical ventilation (<jats:italic>P<\/jats:italic> &lt;. 0001), and oxygen supplementation (<jats:italic>P<\/jats:italic> =. 0040) were significantly greater in frequency among neonates. For all children preoperatively, ASA class (<jats:italic>P<\/jats:italic> &lt;. 0001), chronic lung disease (<jats:italic>P<\/jats:italic> =. 0019), oxygen supplementation (<jats:italic>P<\/jats:italic> &lt;. 0001), and prematurity (<jats:italic>P<\/jats:italic> =. 0016) had a significant impact on prolonged length of stay. Neonates had a persistent requirement for postoperative mechanical ventilation (<jats:italic>P<\/jats:italic> &lt;. 0001) and a prolonged length of stay (<jats:italic>P<\/jats:italic> &lt;. 00001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Neonates undergoing CCA repair are more likely to have a persistent requirement for postoperative mechanical ventilation and a prolonged length of stay. Recognition of key clinical factors may aid in optimizing perioperative risk assessment, patient counseling, and procedural planning.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599818797282","type":"journal-article","created":{"date-parts":[[2018,8,28]],"date-time":"2018-08-28T04:41:50Z","timestamp":1535431310000},"page":"920-926","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Congenital Choanal Atresia Repair: An Analysis of Adverse Perioperative Events"],"prefix":"10.1002","volume":"159","author":[{"given":"Vijay A.","family":"Patel","sequence":"first","affiliation":[{"name":"Division of Otolaryngology\u2013Head and Neck Surgery Department of Surgery College of Medicine The Pennsylvania State University Hershey Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jad","family":"Ramadan","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery School of Medicine West Virginia University Morgantown West Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele M.","family":"Carr","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery School of Medicine West Virginia University Morgantown West Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,8,28]]},"reference":[{"key":"e_1_2_8_2_1","first-page":"1095","article-title":"Congenital choanal atresia in infants and children","volume":"70","author":"Flake CG","year":"1961","journal-title":"Ann Oto Rhino Laryngol"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLG.0b013e3181639b91"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200302000-00011"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4939-1610-8"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.99.3.363"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/hmg\/ddx031"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.47338\/jns.v3.69"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2017.05.023"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otot.2018.03.008"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-5876(86)80010-6"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0b013e3181843564"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(85)80535-7"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.sempedsurg.2008.02.009"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599815575711"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1089\/lap.2014.0298"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26044"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2009.10.023"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000001585"},{"key":"e_1_2_8_20_1","unstructured":"American College of Surgeons.ACS NSQIP Participant Use Data File.https:\/\/www.facs.org\/quality\u2010programs\/childrens\u2010surgery\/pediatric\/program\u2010specifics\/quality\u2010support\u2010tools\/pufPub\u2010lished October2017. 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