Choanal atresia: endoscopic trans-nasal approach

The objective of this study is to present our experience in the endoscopic management of the choanal atresia and evaluate the effectiveness of the diode laser employment in the trans-nasal surgery of this rare congenital malformation. A retrospective review of children treated at the Airway Endoscopic Surgery Unit of Padua Hospital for unilateral and bilateral choanal atresia was made. From 1985 up to 2000, 43 children affected by this malformation were treated in our department. All the patients underwent a trans-nasal approach. In 33 children, a trocar was used in order to perforate the bony atresia. A contact-diode laser was employed to enlarge the choanal lumen after trocar surgery in four cases, whereas six patients underwent the section of the atresia only by laser. In 32 patients, an intranasal stent (Portex endotracheal tube) has been positioned. Forty patients are, at the present time, asymptomatic with satisfied choanal patency. In conclusion, we can state that the transnasal endoscopic approach provides a minimally invasive method to treat unilateral and bilateral choanal atresia. Furthermore, the employment of diode laser improves the outcome by reducing the intraoperative risk, postoperative complications and recurrences. D 2003 British Association for Paediatric Otorhinolaryngology (BAPO). All rights reserved.