Choanal Atresia Repair without the Need for Stenting or Drilling: A Technical Modification

We would like to present our modified technique to repair choanal atresia without the need for drilling or postoperative stenting. Traditional repairs utilise postoperative stents for a variable period [1,2]. Stent-less repairs have been mostly transnasal requiring the raising of mucosal flaps and lateral drilling leading to circumferential scarring [3,4]. Our technique is performed under general anesthesia with oral intubation. The nose is decongested with 0.05% xylometazoline hydrochloride solution. Examination is performed with a 2.1 mmrigid endoscope. After insertion of an oral gag, a suture is used to retract the soft palate forwards. The atretic choanae are visualizedwith a 120° rigid endoscope transorally figure 1a. Urethral sounds (5F to 21F) are used to dilate the membranous portion of the choanae transnasally and can be seen transorally figure 1b. A small part of the posterior vomer is removed using paediatric back-biters figure 1c and redundant mucosa covers the exposed bone of the posterior septum.