PMC9985421_01
Sagittal (A and B) and axial (C) CT images of the paranasal sinuses in bone window settings demonstrate thickening of the vomer (in C), medialization of the pterygoid plates (in C) and membranous bridging of the remaining choanal opening. Minimal retained secretions are seen in the nasal cavities. A lower axial section (D) shows bipartite atlas, in which both anterior and posterior arches of C1 are unfused.
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With the suspicion of a sinonasal pathology, non-contrast CT of the paranasal sinuses (Figure 1) was done.
Nasal endoscopic images of the right (A) and left (B) nasal cavities demonstrate atretic plates in the posterior aspects of the nasal cavities bilaterally.
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Nasal endoscopy (Figure 2) clearly demonstrated the atretic plate.
Intraoperative nasal endoscopic images show patency of the right (A) and left (B) choanae.
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With the diagnosis of bilateral mixed choanal atresia, transnasal endoscopic choanoplasty (Figure 3) was done on an elective basis.
Nasal endoscopy images of the right (A) and left (B) nasal cavities 5 weeks post-op show patent choanae bilaterally.
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Nasal endoscopy images obtained on her 5th post-operative week (Figure 4) shows patent bilateral choanal openings.