Transnasal Correction of Choanal Atresia

A simple life-saving modification of the transnasal approach, which does not require endotracheal anesthesia or preoperative tracheostomy, is described. The use of polyethylene tubes, flanged at the distal end and split at the proximal end, is the most significant feature of this technique. In 14 of the 16 cases of choanal atresia presented, this was the definitive corrective procedure, and further revisions or a later transpalatal approach were not required. The advantages of this technique are that it is simple, it may be used in the first 24 hours of life or at any age, the patient may be released from the hospital in 1 to 2 weeks, and minimal postoperative care is required.