title: Combined transoral-transnasal approach in the repair of congenital posterior choanal atresia: clinical experience.
abstract: BACKGROUND
  A myriad of techniques have been described for managing posterior choanal atresia over the years, yet no standardized surgical protocol has been established.
  
  
  OBJECTIVE
  To present our experience with the transoral-transnasal approach for repairing posterior choanal atresia.
  
  
  METHODS
  A prospective study of children with posterior choanal atresia treated at Ain Shams University Hospitals from 2006 to 2010. Thirteen children affected by this malformation underwent a transoral-transnasal approach by the authors using a standardized surgical technique. All patients were followed up for a period ranging from 6 months to 3 years. Stents were used in neonates, and topical mitomycin C was applied in follow-up when cases needed further dilatation after the first intervention.
  
  
  RESULTS
  Patient demographics were obtained. Stents were used in 11 cases, and mitomycin C was used in 9 cases. Complications were as follows: 1 case had palatal perforation that healed spontaneously, 2 cases had restenosis and were lost to follow-up, and of the other 11 cases, 3 needed no further management and 8 cases needed further dilatation.
  
  
  CONCLUSIONS
  The aforementioned combined transoral-transnasal technique provides a good alternative for managing posterior choanal atresia with easier, four-handed surgery to ensure adequate posterior choana for nasal breathing, but it usually needs multiple sessions.
authors.affiliation: Department of Otorhinolaryngology, Ain Shams University, Cairo, Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Hassan
authors.forename: Tamer
authors.initials: T
authors.lastname: AboEl-Ezz
authors.forename: Tamer
authors.initials: T
authors.lastname: Youssef
mesh_terms: D000293:Adolescent; D002648:Child; D002754:Choanal Atresia / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D014057:Tomography, X-Ray Computed