Image-guided endoscopic and microdebrider assisted repair of choanal atresia in a neonate

Endoscopic transnasal repair of choanal atresia in a 3-week-old infant with CHARGE syndrome under image guidance was employed. Image guidance provided optimal visualization of aberrant bony structures in this small syndromic patient, thus optimizing safety in avoiding damage to vital structures at the skull base. Furthermore, successful endoscopic repair avoided a tracheotomy and expedited extubation. Considering the number of syndromic patients with aberrant skull base and nasal anatomy, image-guided endoscopic repair for choanal atresia may improve safety by avoiding compromise of vital structures at the skull base, particularly in very small neonates. Fiducial marker registration versus laser surface registration is a key consideration in neonates as well as midface deficient patients. (C) 2008 Elsevier Ireland Ltd. All rights reserved.