Surgical correction of choanal atresia in the neonate

The purpose of this paper is to present a technique of endonasal puncture and stenting for bilateral choanal atresia in the neonate that is easily performed and may be definitive. The procedure described is original only in its details, its broad principles are well known. A method of placing the nasal stent is reported that is particularly applicable in the premature, even as small as five pounds. No antibiotics or steroids are given in the postoperative period. Three months is the recommended duration of stenting. Four patients were operated on using this technique, between July 1978 and August 1979; 3 were complete successes; 1 was a bilateral failure, but was re-operated on and was then a unilateral success. Shortest follow-up was 16 months. We feel endonasal puncture and stenting of bilateral choanal atresia in the neonate can be definitive, and is the first procedure of choice.