Low birth weight neonatal choanal atresia repair using image guidance.

This case report demonstrates a novel technique for image-guided choanal atresia repair in the undersized neonate. A surgical navigation system (Stryker, Inc., Kalamazoo, MI) face mask was applied in an "inch-worm" technique facilitating a registration "work-around," also detailed here, to permit intraoperative image guidance despite the patient's small head size. At age 10 days, the premature neonate underwent successful image-guided endoscopic repair of bilateral choanal atresia, permitted by a unique adaptation of face mask application and registration technique. This report presents the smallest weight patient in the literature to date to undergo image guidance during transnasal bilateral choanal atresia repair.