Congenital bilateral adult choanal atresia: Transnasal endoscopic coblation assisted correction

Abstract

Background: Choanal atresia (CA) can be defined as a failure to develop the communication between the nasal cavity and nasopharynx. May occur as a plate osteo-membranous, bony or membranous. Bilateral congenital CA that presents in adulthood is extremely rare. The aim of this presentation is to describe clinical features, diagnosis and the outcome of transnasal endoscopic coblation assisted correction in adult patient. Case presentation: Twenty-six years old Ugandan female presented to Ear, Nose and Throat outpatient clinic in AlWakra Hospital, Qatar, suffered from nasal obstruction, snoring and bilateral, discharge and there was no history of nasal instrumentation or exposure to radiation. Nasal endoscopy revealed nearly complete obliteration of posterior choana on both sides with left sided pin point hole, and right sided very small hole (2–3 mm). Non-contrast computerized tomography of nose showed bilateral membranous CA. Endoscopic transnasal coblation assisted correction was planned and done, nasotracheal tube used as stent, and removed after six weeks. Fourteen months after the procedure, revealed patent posterior choana on both sides. Conclusion: Congenital bilateral CA is an extremely rare condition in adults. Nasal endoscopy and preoperative computed tomography help to guide the surgical procedure. Transnasal endoscopic coblation assisted correction provide less traumatic, with very minimal bleeding, and a faster time for the procedure.

Keywords

• Bilateral congenital
• Choanal atresia
• Adult
• Coblation