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Our technique is performed under general anesthesia with oral intubation. The nose is decongested with 0.05% xylometazoline hydrochloride solution. Examination is performed with a 2.1 mm rigid endoscope. After insertion of an oral gag, a suture is used to retract the soft palate forwards. The atretic choanae are visualized with a 120° rigid endoscope transorally (Figure 1a). Urethral sounds (5F to 21F) are used to dilate the membranous portion of the choanae transnasally and can be seen transorally (Figure 1b). A small part of the posterior vomer is removed using paediatric back-biters (Figure 1c) and redundant mucosa covers the exposed bone of the posterior septum.

Choanal Atresia Repair without the Need for Stenting or Drilling: A Technical Modification