Choanal atresia. Clinical considerations for management.

Taking cognizance of the embryology and newer diagnostic techniques, the transpalatal route is strongly recommended as the optimal surgical procedure for the management of choanal atresia. It should be performed as soon as general anesthesia can be safely administered. In selected instances, but particularly when a patient is at increased surgical risk, necessitating surgical brevity, the endonasal puncture technique should be considered as the initial procedure. Parents must be appraised of the potential for subsequent growth deficiencies, mental retardation, and crossbite.