PEDIATRICS Vol. 76 No. 3 September 1985, pp. 429-436
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Congenital Posterior Choanal Atresia

Richard S. Stahl MD1 and M. J. Jurkiewicz MD1

1 From the Emory University Affiliated Hospitals and Sections of Plastic and Reconstructive Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut, and Emory University School of Medicine, Atlanta

Although described more than two centuries ago, congenital choanal atresa remains an entity for which optimum treatment is not yet established. In a study of 29 cases of congenital choanal atresia during a 14-year period, 14 male and 15 female patients were diagnosed, in contrast with the 2:1 female-male ratio usually reported. Thirty-two operative procedures were performed on 16 surgically treated patients in the series. The two classes of surgical treatment, transpalatal and transnasal techniques, were marked by 66% and 73% recurrence rates, respectively, from 2 months to 6.5 years of follow-up. In previous studies, facial growth disturbances have been shown to result from transpalatal resection in the growing child, whereas transnasal techniques have been indicted as a cause of serious neurologic complications. Because no major morbidity resulted from 20 endonasal procedures in this series, early serial endonasal perforation is advocated as a means of establishing and maintaining a patent nasal airway until definitive transnasal repair can be performed when facial growth is more complete.

Key Words: choanal atresia • upper airway obstruction

Submitted on August 23, 1984
Accepted on November 20, 1984