Diagnosis and treatment of congenital choanal atresia

Choanal atresia is the developmental failure of the posterior nasal cavity to communicate with the nasopharynx. Because of its rare incidence, otolaryngologists have limited experience in treating this unusual congenital anomaly. We report the case of a seventeen year old female with bilateral membrano-osseous choanal atresia who miraculously survived her anomaly and was not definitively diagnosed and surgically treated until she was seventeen. Definitive surgical correction of choanal atresia is challenging. The various methods advocated include the transnasal, transpalatal, trans-septal and sublabial approaches. We will discuss the various treatment options and relate our own personal experience in the management of choanal atresia. A review of the literature on the various modalities available for surgery, stenting and rehabilitation will be discussed also.