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Abstract: Acquired choanal stenosis or atresia is a rare disease seen in otorhinolaryngologic practice, being most of the time not considered in the differential diagnosis of progressive nasal obstruction. The purpose of this paper is to present a case of bilateral acquired choanal stenosis associated with Wegener's granulomatosis. A 41-year-old white female presenting granulomatosis was referred to the Clinical Division of Otorhinolaryngology of the Medical School Hospital of São Paulo, in whon slow progressive bilateral nasal obstruction was the predominant symptom over a 5-year period. A nasal purulent secretion with crusts formation was a secondary complaint. The complete otorhinolaryngologic examination included a flexible fiberoptic examination of the nasal cavity and a computerized tomographic scan of the paranasal sinuses, which revealed a bilateral choanal stenosis. The developlnent of the choanal stenosis probably resulted from sistemic necrotizing vasculitis, the typical histopathological lesion of this granulomatosis. The surgical correction was performed through the transpalatal approach. The authors emphasize the importante of correlating vasculitis as one possible etiology of acquired choanal stenosis.
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