Pediatric unilateral isolated choanal atresia is not associated with mandibular condyle hypoplasia

Am J Otolaryngol. 2021 Jan-Feb;42(1):102824. doi: 10.1016/j.amjoto.2020.102824. Epub 2020 Nov 12.

Abstract

Purpose: We hypothesized that the ontogeny of unilateral isolated choanal atresia involves a field defect manifesting as ipsilateral mandibular condylar hypoplasia. The topic is important because the mechanism of the unilateral isolated choanal atresia is unknown.

Materials and methods: Retrospective self-controlled case series. We included 20 patients (2 males and 18 females, ages 2 weeks to 13 years) with unilateral isolated non-syndromic choanal atresia. We studied their high-resolution computed tomographic scans. Two otolaryngologists measured the largest cross-sectional area of the mandibular condyle in the axial plane perpendicular to the posterior border of each mandibular ramus independently. Statistical significance and inter-rater agreement were calculated with paired Wilcoxon rank sum test and Spearman's non-parametric correlation coefficient respectively.

Results: Cross-sectional areas of the condyles ipsilateral to the choanal atresia were not statistically different than those of the contralateral condyle (P = 0.27). Inter-observer agreement of condyle areas was excellent: Spearman's r = 0.85 on the right and r = 0.94 on the left.

Conclusions: In this cohort of children with the rarity of isolated non-syndromic unilateral congenital choanal atresia, no associated mandibular condyle hypoplasia was found. The data suggest that the underlying ontogeny was unlikely attributable to a field defect.

Keywords: Choanal atresia; Condylar hypoplasia; Mandibular condyle.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Choanal Atresia / diagnostic imaging*
  • Choanal Atresia / etiology*
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Mandibular Condyle / abnormalities
  • Mandibular Condyle / diagnostic imaging*
  • Mandibular Condyle / pathology
  • Nasal Cavity / abnormalities
  • Nasal Cavity / diagnostic imaging
  • Nasopharynx / abnormalities
  • Nasopharynx / diagnostic imaging
  • Retrospective Studies
  • Tomography, X-Ray Computed