International Rhinologic Society Rhinology 0300-0729 2026 01 10 Choanal atresia repair in Germany – a comprehensive investigation of the current state of care EN M-S. Yılmaz Topçuoğlu Department of Otorhinolaryngology, University Hospital Heidelberg, Heidelberg, Germany P.J. Schuler Department of Otorhinolaryngology, University Hospital Heidelberg, Heidelberg, Germany J.H. Westhoff Department I, Center for Pediatric and Adolescent Medicine, Medical Faculty Heidelberg, Heidelberg University, University Hospital Heidelberg, Heidelberg, Germany O. Sommerburg Division of Pediatric Pulmonology, Allergy and Cystic Fibrosis Center, Department III, Center for Pediatric and Adolescent Medicine, University Hospital Heidelberg, Member of the German Center for Lung Research (DZL), University Hospital Heidelberg, Heidelberg, Germany L. WucherpfennigDepartment of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University Hospital Heidelberg, Heidelberg, Germany I. Baumann Department of Otorhinolaryngology, University Hospital Heidelberg, Heidelberg, Germany Journal Article 3402 10.4193/Rhin25.318 BACKGROUND: There is often a discrepancy between official recommendations and actual clinical practice on repair of congenital choanal atresia (CA). The objective of this study was to evaluate the current state of care for CA patients in Germany. METHODS: An online survey was conducted in which 108 German ENT departments were consulted on various aspects of CA management, including preoperative diagnosis, surgical procedures, and postoperative care.RESULTS: 65% of the ENT departments only perform CA repairs at over 3 years of age. Flexible nasal endoscopy (69%), hearing tests (41%), and computed tomography (52%) were preoperative diagnosis tools. Posterior vomer was resected in 56% of the ENT departments. Scar- (60%), granulation tissue (38%), and insufficient vomer resections (21%) caused recurrences. Stents were used by 38%. CONCLUSIONS: Elective unilateral CA repair should be performed in time to minimise symptoms. Preoperative hearing tests should be introduced as routine to identify CA patients with hearing problems. The utilisation of preoperative computed tomography should be discussed individually. Only just over half of the participating ENT departments resected posterior vomer parts. This is a significant starting point with the potential to improve the recurrence rates of this patient cohort. Stent use is still quite common iin Germany. This should be changed in the future.