Unilateral choanal atresia is a congenital obstruction of the posterior nasal passage occasionally seen by plastic surgeons. Because of nonspecific symptoms, this diagnosis can be overlooked for quite some time, and the patients may not seek treatment until adulthood. Traditionally, surgical correction has been through a transpalatal approach. Based on our previous orthognathic experience, we decided to use a Le Fort I osteotomy to expose the posterior choanae. By doing so we avoided disrupting the hard palate in an adolescent with a previously repaired submucous cleft who required removal of a unilateral choanal atresia.
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