Congenital choanal atresia treated by laser surgery

Nine patients with choanal atresia have been operated upon with the carbon dioxide laser. Five of the patients had been operated upon before by various methods, and four of the cases were unilateral and untreated before. The operation was performed under general anaesthesia using the operating microscope. The pharyngeal mucosa was protected by a saline-soaked packing in the nasal pharynx. No stent was used in the postoperative period. Normal air passage was obtained in six patients, and one patient, who had co-existing adhesions through the whole nasal cavity after previous treatment by dilation, achieved a limited air passage after one laser treatment, and further attempts were postponed until he grew older. One patient did not want another try after one failure. One patient has been operated recently, and the result is uncertain. Laser-treatment of choanal atresia seems to make other methods of operation obsolete for the following reasons: The operation is easy and quick and of slight discomfort to the patient. The time of hospitalization is short, and the operation can be repeated, if a good result is not achieved in the first try. And most important is the fact, that no stent is needed.