There are only three cases of bilateral choanal atresia in adults reported in the literatures 3,5,6. 3 reported a 22-year-old patient with bilateral choanal atresia. The passage in this patient was established via a transnasal endoscopic approach using a 2. It is always present at birth and almost always diagnosed then or shortly after. Even adults who had choanal atresia as a baby often do not suffer any lingering after-effects. endoscopic choanal atresia repair in 20 year old, unilateral nasal obstruction, b. Endoscopic bilateral congenital choanal atresia repair of 112 cases, evolving concept and technical experience. Association of nasomaxillary asymmetry in children with unilateral cleft lip and palate and their parents. Adult choanal atresia is a rare congenital malformation of the nasal cavity characterized by the complete obliteration of the posterior choanae, only ninth cases are reported in the literature, we present in our observation the tenth case of adult bilateral choanal atresia. choanal atresia was first described by johann roderer in 1755. Congenital choanal atresia is unilateral or bilateral occlusion of the posterior nasal orifices. Being a rare abnormality, seen in 1 out of 5000-7000 live births , it is associated with other congenital abnormalities in 50 of the cases , and is twice as common in females. a video showing nasal scar and choanal atresia repair in an adult. Choanal atresia happens in the womb when the passages in the nose dont fully open and connect with the airway as the baby develops. Doctors dont know exactly what causes it, but they think a. Choanal atresia seen during exam choanal atresia is a congenital narrowing of the back of the nasal cavity that causes difficulty breathing. It is rare, occurring in approximately 1 in 7,000 live births, and is seen more often in females than in males.