An oral airway, McGovern nipple, and intubation are viable options. The ideal procedure for choanal atresia restores the normal nasal passage, prevents damage to growing structures important in facial development, is technically safe, requires short operative time, and provides short hospitalization and convalescence. Procedures Transnasal puncture, with or without a microscope, became unpopular because of the high rate of failure requiring revision. This was attributed to the difficulty in visualizing the choanal area that required special surgical attention, such as the vomerine septal bridge and bony narrowing of the lateral walls. The transnasal approach becomes more difficult in the presence of septal deviation, turbinate hypertrophy, nasal discharge, and elongation of the depth from the nasal vestibule to the posterior choanae as patients grow.
Transseptal technique consists of making a window in the septum anterior to the atretic plate.
Transpalatal repair is a technique that provides excellent exposure and has a high success rate but needs more operative time. This technique has excellent long-term results. The time of hospitalization is short, and the operation can be repeated if a good result is not achieved initially. Most importantly, a stent usually is not needed. Stenting usually is performed using an endotracheal tube or Foley catheter.