Abstract : Objective: The purpose of this study is to assess the effect of trans-nasal endoscopic management of choanal adenoid in management of the adult patient with persistent nasal symptoms. Patients and methods: This study conducted on 40 patients with bilateral nasal obstruction not responding to medical treatment of the nasal symptoms. The youngest patient's age was 18 years and the oldest was 43years (mean22.9± 7.4). Diagnosis preoperative was based on a careful history, examination including nasal endoscopy to confirm the diagnosis. Phoniatrics evaluation included (APA) and, Nasometery and examination including nasal endoscopy to confirm the diagnosis. A transnasal endoscopic powered adenoidectomy using a microdebrider in all patients to remove the choanal adenoids Results: A high statically significant difference between the nasal symptoms pre and post-operative follow up. Our patients had different degrees of improvement in the three follow up post-operative as regards the degree of nasal obstruction, Nasal discharge, Snoring, Chronic cough, Degree of crustations, and Degree of intranasal adhesions, and nasal bleeding. Conclusion: Our results revealed that the microdebrider is one of the best tools in removing chonal adenoid completely and relief most of nasal symptoms.

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