ABSTRACT
Choanal atresia is a well-recognized congenital defect characterized by obstruction in the posterior nasal apertures, usually by bone or soft tissue, secondary to failed recanalization of the nasal fossae during fetal development. The clinical presentation of choanal atresia is dependent on whether the deformity is unilateral or bilateral and the presence of other coexisting comorbidities. Bilateral choanal atresia presents as an airway emergency at birth, since neonates are obligate nasal breathers for the first 6 weeks of life. Traditional plain radiography in the supine position with the nasal cavity filled with radiopaque contrast has been replaced by computed tomography (CT). Prior to the availability of CT, the histological distribution of choanal atresia cases was estimated as 90" bony and 10" membranous. The transpalatal approach is associated with a higher complication rate compared to endoscopic techniques. In addition to stents, the antineoplastic agent mitomycin C has been used as a treatment adjunct to try to decrease stenosis.
