Reconstruction of the choana in a teenager with congenital unilateral choanal atresia after multiple choanal surgery. Case report

Choanal atresia (CA) is a congenital pathology, the frequency of which currently stands at 1 in 8000 newborns. The cause of congenital choanal atresia has not been definitively established at the moment. Diagnosis of CA often is made by pediatricians or neonatologists in the ICU oh the maternity hospital. In case of bilateral CA diagnosis is often not difficult and the diagnosis is often suggested right after labor due to asphyxia, but with a unilateral process, children can live for years without nasal obstruction in case of compensated nasal breathing. Today approaches to CA repair in children remain controversial. And if, in a bilateral process, surgical intervention is recommended to be done as early as possible, in case of the correction of the unilateral process may be postponed until older age. There is also no clear opinion on the approaches to surgical approaches, the use of protectors, the duration of their installation and the type of protector used is also controversial. The article describes a clinical case of adolescent with bilateral CA with multiple choanoplasty surgeries and restenosis. The child was admitted to Otorhinolaryngology Department of the Veltischev Research and Clinical Institute of Pediatrics and Children surgery. Despite the diagnosis that was made on time, the patient managed to improve nasal breathing only by the age of 15 after choanal reconstruction.