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A rare case report of bilateral choanal atresia in an adult.

INTRODUCTION: Adult choanal atresia is a rare congenital malformation of the nasal cavity characterized by the complete obliteration of the posterior choanae, only ninth cases are reported in the literature, we present in our observation the tenth case of adult bilateral choanal atresia.

PRESENTATION OF CASE: A 18-year-old man presented at our department with complaints of nasal obstruction, nasal discharge, snoring, anosmia, and mouth breathing since childhood. Endoscopic examination and paranasal sinus tomography revealed bilateral choanal atresia. An endoscopic choanoplasty was performed. Follow-up evaluation at postoperative 12th month showed that his symptoms improved significantly and, on endoscopic examination, both choanae remained patent.

DISCUSSION AND CONCLUSION: Adult bilateral choanal atresia is a rare entity. The revelation in adulthood of congenital bilateral atresia remains exceptional. Nasal endoscopy and preoperative computed tomography scan help in planning surgery. Endoscopic transnasal choanoplasty is the criterion standard treatment. The exact role of the postoperative stent and use of mitomycin C is controversial.

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