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

Patient with five fiducial markers placed around face used as registering landmarks for the image-guidance system during surgery.

Endoscopic view of right-sided nasal cavity (a) and atretic plate (b). Preoperative sagittal view demonstrating posterior extension of hard palate to skull base (c). Intraoperative sagittal view of probe being used to create connection from nasal cavity to pharynx (d). Intraoperative sagittal view of probe abutting the skull base (e). Without image-guidance, this could be mistaken for the bony atretic plate.

(a) Microdebrider used to enlarge choanal opening. (b) Right nasal choana prior to stenting.