gms | German Medical Science

76th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

04.05. - 08.05.2005, Erfurt

A Transnasal Endoscopic Diode Laser Resection of a Bilateral Choanal Atresia of a Premature Infant

Meeting Abstract

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  • corresponding author Frank Wallner - Dep. of Otolaryngology, Heidelberg
  • Bibiana Kotrikova - Dept. of Maxillofacial Surgery, Heidelberg
  • Ralph Dollner - Dept. of Otolaryngology, Leipzig

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. 76. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e.V.. Erfurt, 04.-08.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc05hno091

The electronic version of this article is the complete one and can be found online at:

Published: September 22, 2005

© 2005 Wallner et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



A premature infant (initial weight 2130 g) had to be delivered by caesarian sectio because of placental insufficiency. As she showed no spontaneous respiration, a nasal intubation was tried, but failed on both sides. Finally an orotracheal intubation was done. The CT and MRI scans showed a dysplasia of the vomer, that broadened like a wedge and obstructed both sides of the nasal cavity. Multiple malformations were also present, not fulfilling the criteria of the CHARGE syndrome. On the twentieth day after birth the dysmorphic vomer was resected, using an endoscope and a diode Laser, attaching the Laser glass fibre to a thin metal sucktion by adhesive tape. During the healing process no stenoses occured. Only in the central hard palate a secondary perforation occured after one week, probably as a result of circulatory disorder. It was closed by a flap forteen month later. Bilateral choanal atresias have to be treated immediately because of the severe impairment of breathing and drinking of the infant. In this case, the very small anatomical dimensions were surgically challenging. The diode Laser with it's good hemostasis and little tissue penetration proved to be a useful tool.