Orthopedic palatal expansion in the treatment of bilateral congenital choanal atresia : an additional tool in the long term follow up of patients?

Objective Rapid Palatal Expansion (RPE) is an orthodontic procedure commonly used to widen the maxilla. Aim of this study is the description of the effects produced by RPE in two patients affected by Bilateral Congenital Choanal Atresia (BCCA) operated in infancy and who were scheduled for a secondary endoscopical surgical correction. Methods The two cases presented were studied through Postero Anterior and Submental Vertex cephalometric x-rays, and TC-Scans pre and 12 months post expansion. Results Both nasal and choanal widths were increased 12 months post expansion of an amount which was equivalent to 30% of the defective bony whidth. Endoscopically the expansion of the lumen was more evident given the associated soft tissue improvement. In both cases secondary surgery was avoided. Conclusion The cooperation between ENT surgeon and orthodontist may allow for an reduction in the burden of treatment of children affected by BCCA.