ABSTRACT
Choanal atresia is a congenital abnormality in which the
nasal cavity does not open into the nasopharynx (Fig. 24.1).
The malformation was first described in 1755 by Roederer.1
The condition may be either unilateral or bilateral. Bilateral
choanal atresia presents acutely in the neonatal period with
respiratory distress, in view of the fact that the neonate lacks
the ability to mouth breathe. A unilateral defect may go
undetected for months or even years prior to diagnosis.
Treatment involves surgical repair of the defect and has
evolved from transmaxillary, transeptal, transpalatine, and
sublabial intransal approaches to modern endoscopic tech-
niques. Despite the acceptance of the endoscopic approach as
the current gold standard, controversies still exist in how to
best manage patients with this condition, particularly
regarding the use of adjuvant topical medications following
the surgical repair and the use and duration of postoperative
