TRANSPALATINE SURGERY FOR CONGENITAL BILATERAL CHOANAL ATRESIA

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Abstract
Congenital bilateral choanal atresia was reported first as an observation at autopsy by Otto in 1829. Medovy and Beckman have collected 115 cases from the literature up to 1945. Subsequently Owens, Cohen and Witchell, Hanckel, Aboulker, Whitehouse and Holt, and Johnson have added eight cases. Flake has treated a series of 25 patients not reported on. The anomaly probably results from an abnormal embryologie development. In the formation of the nasal passages, the nasobuccal membrane invaginates into the forming nose and migrates posteriorly as a blind pouch. Similarly, the buccopharyngeal membrane moves into the choanal area from the posterior aspect. Normally, the two rupture at their points of contact and the nasal passages are formed. Persistence of either membrane or the mesodermal elements between them gives rise to an occlusion of the choanae that may involve one or both sides. Ninety per cent of these obstructions are bony. The birth

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