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June 1966

Transnasal Correction of Choanal Atresia: Microsurgery in the Newborn

Author Affiliations

From the division of Otolaryngology, University of Vermont College of Medicine, Burlington, Vt.

Arch Otolaryngol. 1966;83(6):607-609. doi:10.1001/archotol.1966.00760020609025

SLIGHTLY over 100 years ago the first recorded correction of choanal atresia was done by Emmert, who opened the atretic area with a curved trochar through the nose. In the ensuing century a variety of techniques and instruments have been used. These include transnasal use of electrocoagulation, carpenter's bits, hand drills, curets, rongeurs, and urethral dilators.1-4 In the early 1930's the first successful transpalatal approach was done.5 Transantral and transseptal routes were developed but were never used widely.6

Beinfield has in recent years continued to advocate the transnasal correction of choanal atresia. His latest technique in infants is to use a mastoid curet in opening the bony defect to destroy the mucous membrane on the nasal side, preserving the pharyngeal mucosa. A stellate incision is then made in the pharyngeal mucosa with the surgeon's finger in the nasopharynx as a guide. The pharyngeal membrane flaps are pulled

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