Abstract
Choanal atresia or stenosis (CA/S), whether congenital or acquired, is a rare but clinically significant condition characterized by the obstruction of the posterior nasal aperture. While congenital bilateral choanal atresia (CA) poses an immediate life-threatening risk in neonates due to obligate nasal breathing, unilateral CA may go unnoticed for several years. Acquired forms-particularly post-radiation-are increasingly recognized for their morbidity and impact on quality of life. We present five cases of CA having varied presentation from congenital non syndromic unilateral/bilateral CA to syndromic bilateral CA along with acquired cases of CA post radiotherapy for head and neck malignancies. This case series combines our experience with both congenital and acquired types of choanal atresia, offering a unique comparative perspective on their presentation, diagnosis, and surgical management.