The authors discuss the different approaches in surgical treatment of choanal atresia. They describe a method of endonasal approach under optic control. In this method an opening in the bony atresia is made via the nasal cavity with the aid of a surgical microscope and micro-instruments, while the posterior wall of the atretic plate is observed by means of a 110 degrees endoscope via the nasopharynx. This method is illustrated by a clinical case, with a four year follow-up.

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