Nine cases of bilateral choanal atresia are reported. The association with other malformations and deafness is evaluated. The choanal atresia is associated with multiple malformation in two cases and bilateral deafness in 5 cases. Before discussing surgery, a complete evaluation has to be performed, deafness has to be evaluated with modern electrophysiological methods. The risks of the surgery should be considered in case of cardiac malformation and cerebral anoxia.