Choanal atresia

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ICD9 = | ICDO = | Image = | Caption = | OMIM = 608911 | MedlinePlus = 001642 | eMedicineSubj = ent | eMedicineTopic = 330 | DiseasesDB = 31330 |Choanal atresia is a congenital disorder where the back of the nasal passage (choana) is blocked, usually by abnormal bony or soft tissue formed during fetal development.

Presentation

It can be unilateral or bilateral. Sometimes, a unilateral choanal atresia is not detected until much later in life because the baby manages to get along with only one nostril available for breathing.Bilateral choanal atresia is a very serious life-threatening condition because the baby will then be unable to breathe directly after birth as babies are obligate nasal breathers (they must use their noses to breathe). In some cases, this may present as cyanosis while the baby is feeding, because the oral air passages are blocked by the tongue, further restricting the airway. The cyanosis may improve when the baby cries, as the oral airway is used at this time. These babies may require airway resuscitation soon after birth.

Associated conditions

Sometimes babies born with choanal atresia also have other abnormalities:
  • coloboma
  • heart defects
  • mental retardation
  • growth impairment
  • others (see also CHARGE syndrome)

    • Diagnosis

    Choanal atresia can be suspected if it is impossible to insert a nasal catheter. Diagnosis is confirmed by radiological imaging, usually CT scan.

    Treatment

    Temporary alleviation can be attempted by inserting a catheter into the mouth, leading to the airway. However, the only definitive treatment is surgery to correct the defect.

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