OBJECTIVE: To evaluate current concerns about transnasal endoscopic repair of bilateral congenital choanal atresia, regarding technical difficulties, prognostic factors and important controversies. PATIENTS AND METHODS: Ten infants with bilateral congenital choanal atresia, aged from 3 to 27 days (mean, 11.2 days) were included. All cases underwent transnasal endoscopic repair and were clinically and endoscopically monitored. RESULTS: Of the seven patients treated with stenting, five remained patent and two required minor debridement (with complete patency thereafter). Of the three patients treated without stenting, one remained patent and two required minor debridement (with patency thereafter). CONCLUSIONS: Transnasal endoscopic repair of bilateral congenital choanal atresia is a safe and successful technique. The use of powered instrumentation in neonatal patients requires experience and a correctly sized drill. Stenting with an appropriate nasal tube for a suitable period is favoured, especially in hospitalised patients.
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