{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T16:38:26Z","timestamp":1788107906183,"version":"build-2803163510"},"reference-count":29,"publisher":"BMJ","issue":"11","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,10,19]]},"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:p>We present a case of a 2-month-old patient with CHARGE syndrome, cerebral haemorrhage and bilateral congenital choanal atresia (CCA). He was admitted to our otorhinolaryngology unit to solve his congenital bilateral choanal atresia proposing a transnasal endoscopic surgery. A study of CT of the skull showed that the air column was interrupted on both sides of nasal cavities; a nasal endoscopy with neonatology flexible optics showed the presence of a membrane and bony structure obstructing the passage into the nasopharynx. Preoperative brain magnetic resonance (MRN) has been made. We decided to carry out a transnasal endoscopic neuronavigation approach with multi-flaps without stenting apposition to solve the CCA, using a 0\u00b0 2.7-millimetre rigid endoscopic and Skeeter-type drill with a 2.3-millimetre microblade cutter. Postoperative nasal care was essential to avoid recurrences. Endoscopic follow-up was performed; a large uni-neochoane was residual at 3 months, all raw surfaces were covered by multiple mucosal flaps welded with fibrin.<\/jats:p>","DOI":"10.1136\/bcr-2021-245815","type":"journal-article","created":{"date-parts":[[2021,11,2]],"date-time":"2021-11-02T13:43:22Z","timestamp":1635860602000},"page":"e245815","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Congenital bilateral choanal atresia: an endoscopic approach with multi-flaps supported by neuronavigated CT"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7226-4596","authenticated-orcid":false,"given":"Cosimo","family":"Galletti","sequence":"first","affiliation":[{"name":"Department of Adult and Development Age Human Pathology \u201cGaetano Barresi\u201d, Unit of Otorhinolaryngology, Universita degli Studi di Messina, Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Freni","sequence":"additional","affiliation":[{"name":"Department of Adult and Development Age Human Pathology \u201cGaetano Barresi\u201d, Unit of Otorhinolaryngology, Universita degli Studi di Messina, Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Ciodaro","sequence":"additional","affiliation":[{"name":"Universita degli Studi di Messina, Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Galletti","sequence":"additional","affiliation":[{"name":"Department of Adult and Development Age Human Pathology \u201cGaetano Barresi\u201d, Unit of Otorhinolaryngology, Universita degli Studi di Messina, Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,11,2]]},"reference":[{"key":"2025082707004014000_14.11.e245815.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2017.04.022"},{"key":"2025082707004014000_14.11.e245815.2","first-page":"CD008993","article-title":"Surgery for congenital choanal atresia","volume":"2","author":"Cedin","year":"2012","journal-title":"Cochrane Database Syst Rev"},{"key":"2025082707004014000_14.11.e245815.3","first-page":"127","article-title":"Endoscopic choanal atresia repair","volume":"73","author":"Gallagher","year":"2012","journal-title":"Adv Otorhinolaryngol"},{"key":"2025082707004014000_14.11.e245815.4","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1016\/j.clp.2018.07.011","article-title":"Choanal atresia and other neonatal nasal anomalies","volume":"45","author":"Rajan","year":"2018","journal-title":"Clin Perinatol"},{"key":"2025082707004014000_14.11.e245815.5","unstructured":"Andaloro C , Mantia L . 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