Background and Objectives:Congenital choanal atresia is a relatively uncommon disease whose causes can be explained
by embryological etiology. To date, many authors have expressed various opinions about the timing of surgery and surgical
approach. We retrospectively analyzed 7 cases of congenital choanal atresia to find out the treatment results and to propose
the timing of surgery and the method of surgical approach. Materials and Methods:Seven congenital choanal atresia
patients who had been treated between 1981 to 1997 were retrospectively analyzed with charts and X-ray reviews. The
symptoms, associated anomalies, site of atresia, features of the atretic plate, surgical approaches, duration and materials used
for stenting, reoperation, duration and results of follow-up were analyzed. Five patients were female and 2 patients were
male. Associated anomalies were observed in 1 case (14%). Of 6 patients who underwent surgery, 3 received transnasal
approach the other 3 received the transpalatal approach. The atretic site was bilateral in 5 cases (71%) and unilateral in 2
cases (29%). Stent was used in all surgical cases. Results:Of the 10 sides evaluated, bony atresia was observed in 3 sides
(30%), membranous atresia in 2 sides (20%), and mixed bony-membranous atresia in 5 sides (50%). Three patients who
were treated by transpalatal approach and 1 patient who was treated by transnasal approach were successfully treated without
reoperation. Two newborn patients who were treated by transnasal approach could achieve normal growth and development
by mouth feeding and nasal breathing. They had granulation tissue or stenosis of the opening but they were successfully
treated by reoperation and longer period of stenting. Conclusion:We recommend that neonatal congenital choanal atresia
patients should be treated by transnasal approach with longer periods of stenting immediately following the diagnosis.
(Korean J Otolaryngol 2000;43:296-9)