Transnasal endoscopic manage­ment of posterior choanal atresia rep­resents a significant advancement in choanal surgery. It provides an ex­tremely sharp image with a magnified overview. It enables the surgeon to see the tips of his insruments, so that the bone is removed safely under di­rect endoscopic vision. A second look procedure on removal of the stent is essencial to assess the neochoana as regard to its wideness, any granula­tion tissues or polyps.This study in­cluded 26 patients divided into 2 groups. Group I included 11 neonates with bilateral choanal atresia. Group II included 15 patients aged 3-32 years. Endoscopic repair of choanal atresia was performed in all cases followed by a second look procedure after 6 weeks. This study was done in ORL
surgery depatment, Mansoura Univer­sity Hospital at the period between 2000 and 2003. W concluded that en-doscope is essential for management of congenital choanal atresia also the second look procedure is mandatory.