choanal atresia

Introduction

narrowing or blockage of the nasal airway by tissue

Epidemiology

• most common nasal abnormality in newborns
• ~1 in 7,000 live births
• female:male ration 2:1
• > 1/2 of affected infants have other congenital anomalies

Pathology

• occur when the thin tissue separating the nasal passages & posterior oral cavity during fetal development remains after birth
• may affect one or both sides of the nasal airway
• bilateral chonal atresia causes cyanosis & acute respiratory failure

Clinical manifestations

• congenital anomaly
• since newborns are nose breathers & only mouth breathe when they cry, newborns with choanal atresia may cry in order to breath
• chest retracts unless the child is breathing through mouth or crying
• dyspnea, cyanosis, unless infant is crying
• inability to nurse & breathe at same time
• inability to pass a catheter through each side of the nose into the throat
• persistent one-sided nasal blockage or discharge

Diagnostic procedures

• endoscopy of nasal passages

Radiology

• CT scan of paranasal sinuses

Complications

• pulmonary aspiration while feeding & attempting to breathe through the mouth
• respiratory arrest
• restenosis of the area after surgery

Management

• infants with bilateral choanal atresia may need resuscitation at delivery
• surgery to remove obstruction
• if infant learns to mouth breathe, surgery may be delayed
• full recovery is the norm

More general terms

• atresia (atretic, atresic, imperforate)
• congenital anomaly (birth defect)