Trans Nasal Endoscopic Choanoplasty – The Ideal Treatment Option for Choanal Atresia and Stenosis

Abstract

Background: Choanal atresia (CA) is a congenital narrowing or complete obstruction of the posterior nasal aperture and represents the most common congenital anomaly of the nose. Bilateral CA presents as a neonatal airway emergency requiring prompt diagnosis and treatment. Acquired choanal stenosis may occur following trauma, surgery, or inflammatory disorders. Endoscopic transnasal repair has become the preferred management approach because of its high success rate and lower complication profile.

Case Series: The authors describe three different clinical scenarios: congenital bilateral choanal atresia, acquired bilateral choanal stenosis managed with stenting, and acquired bilateral choanal stenosis managed without stenting. All patients underwent endoscopic choanoplasty with resection of the posterior septal plate and medial pterygoid plate. Surgical techniques, postoperative care, and outcomes are discussed along with a review of current literature.

Conclusion: Endoscopic transnasal choanoplasty with resection of the posterior septal plate and medial pterygoid plate provides excellent outcomes in congenital and acquired choanal obstruction. The technique offers a high success rate with minimal morbidity and has become the preferred surgical treatment for choanal atresia and stenosis.