Endoscopic management of choanal obliteration following radiotherapy for nasopharyngeal carcinoma

Acquired choanal obliteration, though rare post-radiotherapy, can result from various factors. Patients usually present with nasal obstruction, rhinorrhoea, anosmia, and hypoacusis. Endoscopy and imaging often reveal scar tissue obstructing the posterior nasal cavity. Surgical treatment is possible but carries a high risk of re-stenosis. This report discusses a case of post-radiotherapy choanal obliteration treated surgically, with the patient maintaining nasal patency after 18 months. Case presentation: A 46-year-old female with nasopharyngeal carcinoma treated with chemo-radiotherapy in 2011 developed progressive nasal obstruction. In 2022, she underwent endoscopic surgery with a U-shaped nasal stent insertion to re-open both nasal cavities. Regular follow-ups and stent maintenance were vital for preserving nasal patency. Conclusion: The case highlights the importance of surgical intervention for choanal atresia post-radiotherapy and underscores the need for diligent follow-up care and nasal hygiene to prevent reoccurrence.