Nasopharyngeal atresia

The nasopharynx stenosis and atresia caused by infection, trauma, etc., make the back of the nasal cavity completely or partially filled, the pronunciation is obstructive nasal sound, and even affects breathing and eating. The best treatment time: general surgery is recommended to be treated after the initial diagnosis of the disease, special surgery should be prescribed.

Treatment of diseases: congenital nasopharynx stenosis and atresia in otolaryngology and trauma

Indication

1. Nasopharyngeal atresia and stenosis of congenital dysplasia.

2. Stenosis and atresia caused by trauma, chemical burns, infections and surgery.

Contraindications

1, there is skull base bone destruction or paranasal infiltration, cranial nerve damage or distant metastasis.

2, there are liver and kidney dysfunction, poor overall condition.

Preoperative preparation

The scope and nature of the lesion should be understood before surgery. The intranasal injection of contrast agent for X-ray examination of the nasopharynx or CT scan can help to define the thickness of the atresia tissue. It can also be understood that the nasopharynx atresia is membranous or bony. .

Surgical procedure

There are two main types of nasopharyngeal atresia surgery: surgery through the hard sputum approach, nasal surgery. The latter is rarely used because of the deep position of the surgical field, poor exposure, and easy damage to the nasal mucosa. The main points of the surgical approach through the hard fistula are described below:

1, supine, slightly padded shoulders, so that the head is stretched back, set the mouthparts, expose the oropharynx.

2, the hard palate site for the periosteal tongue-shaped incision, peeling the periosteum from the anterior to the posterior, until the posterior margin of the hard palate, exposing the large hole and cutting the posterior margin of the bone, so that the aorta is free, the tongue-shaped mucoperiosteal flap is formed.

3, remove part of the hard iliac bone, at the front edge of the atresia, cut the mucosa at the bottom of the nasal cavity, remove the nasopharyngeal atresia tissue, cut off the proliferating bone, and enlarge the posterior nasal cavity.

4. If the soft palate and the posterior pharyngeal wall also have adhesions, it should be cut in a curved shape, the nasopharyngeal cavity should be separated, the submucosal fibrous scar tissue should be removed, and the soft palate and the posterior pharyngeal wall wound should be sutured vertically to reduce the postoperative scar. shrink.

5. Place the pre-made plastic dilatation tube into the posterior nostril or nasopharynx, and fix it on the anterior nares of both sides, and suture the hard palate incision.

complication

Incision delayed healing and wound infection.

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