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choanal atresia
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
Special laboratory:
- 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
General
atresia (atretic, atresic, imperforate)
congenital anomaly (birth defect)
References
- Choanal atresia
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002608/
- Wikipedia: Choanal atresia
http://en.wikipedia.org/wiki/Choanal_atresia
- Tewfik TL
eMedicine (Medscape): Choanal Atresia
http://emedicine.medscape.com/article/872409-overview
- MedlinePlus: Choanal atresia
http://www.nlm.nih.gov/medlineplus/ency/article/001642.htm