title: Choanal atresia.
abstract: Choanal atresia is caused by failure of resorption of the bucco-pharyngeal membrane during embryonic development. The atresia can be membranous or bony in nature, but is usually mixed in most cases. When the atresia is bilateral, newborns can have severe airway distress and cyanosis is alleviated by crying. Bilateral choanal atresia is managed with an oropharyngeal airway. Flexible nasal endoscopy and computed tomography can confirm the diagnosis. Surgery is the definitive treatment with two main approaches, namely transnasal or transpalatal. The transnasal route is currently the preferred procedure and can be performed in a minimally invasive fashion with endoscopic instrumentation. It is a safe and rapid procedure even in very young children, with no complications and a high rate of success. The use of a navigation system for surgical planning and intraoperative guidance and powered instrumentation can improve treatment outcome. The transpalatal approach is more invasive and reserved for failed endoscopic cases.
authors.affiliation: Department of Otorhinolaryngology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand. paraya.assanasen@gmail.com
authors.forename: Paraya
authors.initials: P
authors.lastname: Assanasen
authors.forename: Choakchai
authors.initials: C
authors.lastname: Metheetrairut
mesh_terms: D002754:Choanal Atresia / Q000000981:diagnostic imaging / Q000601:surgery*; D004724:Endoscopy; D006801:Humans; D007231:Infant, Newborn; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome