Puropose: The aim of this study is to do trans nasal endoscopic management of choanal adenoid in 
the adult with persistent nasal symptoms even in the prescence of apparent cause of nasal obstruction. 
Patients and methods: The current study is a prospective study that done at the department of 
Otorhinolaryngology, Minia University hospital to describe transnasal endoscopic powered 
adenoidectomy using a microdebrider in patients with choanal adenoids . A total of 40 patients of 
different age groups and both sexes were involved in the study. We selected adult patients with 
bilateral nasal obstruction not responding to medical treatment. All the adult patients aged from (18 
to 43 years) with adenoid hypertrophy were taken into study.In this study 40 adult patients having 
adenoid were found out by screening of adult patients having nasal obstruction in out patient clinic in 
the Department of otorhinolaryngology Minia University Hospital. These 40patients were evaluated 
and studied. Results: The study was done on 40 patients, 13(32.5%) were only choanal 
adenoidectomy and 27(67.5%) were choanal adenoidectomy with other procedures. fourty patients of 
our study were assessed Ninety days after surgery, As regard postoperative nasal obstruction, 13 
patients (32.5%) had mild nasal obstruction, and 27 patients (67.5%) had moderate nasal obstruction,
and no had severe nasal obstruction at 2 weeks postoperatively. In the present study all of our patients 
had no nasal obstruction (100%) at 3 months postoperatively. As regard postoperative snoring ,In the 
present study 5 patients (12.5%) had no snoring, and 35 patients (87.5%) had snoring at 2 weeks 
postoperatively. In the present all patients had no snoring (100%) at 3 months postoperatively.
Conclusion: Choanal adenoid in adults is uncommon, but rather an important cause of nasal 
obstruction which is usually over-looked or misdiagnosed.