The endoscopic repair of choanal atresia

Since 1755, when choanal atresia was first described by Roederer, more than 300 papers have appeared in the literature dealing with various aspects of choanal atresia. Today's preferred methods of repair are transnasal and transpalatal. Each method has its advantages, disadvantages, proponents, and opponents. The main disadvantage of the transnasal procedure is limited vision, even with a microscope, especially in newborn infants, and the inability to adequately remove enough vomerine septal bone to prevent restenosis. Endoscopic transnasal repair of choanal atresia provides excellent visualization and the ability to perform exact surgery on patients of all ages. Described are four patients who underwent endoscopic repair of choanal atresia. Three of the four have patent nares, one patient after revision surgery. The technique is discussed along with its advantages and disadvantages relative to other surgical treatment modalities.