Choanal atresia is a rare but the most common congenital anomaly of the nasal cavity. Bilateral choanal atresia in an elderly person is extremely rare. This condition occurs due to the persistence of the nasobuccal membrane, which should normally rupture around the 7th week of embryonic development. The only way the patient survives is if there is partial atresia in one of the sides as was present in our patient. Here, we present a case of a 69-year-old woman with bilateral choanal atresia, with the right choana being completely atretic and the left choana partially atretic, the patient underwent transnasal endoscope-guided bilateral choanoplasty and reconstruction using the crossover nasoseptal flap technique and stenting. Transnasal endoscopic choanoplasty is generally considered the treatment of choice for this condition. Restenosis is a common postoperative complication, but proper nasal douching and regular follow-up can help reduce the likelihood of restenosis.
