Choanal atresia

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Choanal atresia
Synonyms
Pronounce	N/A
Specialty	N/A
Symptoms	Nasal obstruction, difficulty breathing, cyanosis
Complications	Respiratory distress, failure to thrive
Onset	Neonatal
Duration
Types	Unilateral, bilateral
Causes	Congenital disorder
Risks	Genetic factors, environmental factors
Diagnosis	CT scan, nasal endoscopy
Differential diagnosis	Nasal septum deviation, adenoid hypertrophy
Prevention
Treatment	Surgical repair
Medication
Prognosis	Generally good with treatment
Frequency	1 in 5,000 to 8,000 live births
Deaths	Rare

Choanal atresia is a congenital condition characterized by the blockage of the choanae, the passages that connect the back of the nasal cavity to the pharynx. It is a significant condition because it can interfere with the ability to breathe, especially in newborns who are obligate nasal breathers. Choanal atresia can be unilateral, affecting one side, or bilateral, affecting both sides.

Causes and Risk Factors

The exact cause of choanal atresia is not well understood, but it is believed to result from an abnormality in the development of the nasal fossae during embryonic growth. Risk factors may include genetic conditions such as CHARGE syndrome, which is an acronym for a constellation of anomalies including Coloboma, Heart defects, Atresia of the choanae, Retarded growth and development, Genital abnormalities, and Ear abnormalities.

Symptoms

Symptoms of choanal atresia can vary depending on whether the condition is unilateral or bilateral. In cases of bilateral choanal atresia, symptoms are more severe and are present immediately after birth. They include difficulty breathing, cyanosis (a bluish discoloration of the skin due to lack of oxygen), and distress during feeding. Unilateral choanal atresia may not be diagnosed until later in life and symptoms can be milder, often including chronic nasal congestion and discharge.

Diagnosis

Diagnosis of choanal atresia typically involves a combination of physical examination and imaging studies. A failure to pass a catheter through the nasal passage into the throat may suggest the presence of atresia. Imaging techniques such as computed tomography (CT) scans are used to confirm the diagnosis and to assess the anatomy of the nasal passages and the extent of the blockage.

Treatment

Treatment for choanal atresia is surgical. The goal of surgery is to create a patent airway that allows for normal breathing and drainage. The specific surgical technique used can vary, but may include transnasal endoscopic surgery or a transpalatal approach. Postoperative care is crucial to monitor for complications and to ensure that the airway remains open.

Prognosis

With appropriate surgical treatment, the prognosis for individuals with choanal atresia is generally good. Early diagnosis and treatment are important, especially in cases of bilateral choanal atresia, to prevent complications related to oxygen deprivation. Long-term follow-up care is often necessary to monitor for potential recurrence of the blockage or other related issues.

See Also

• Nasal congestion
• Pediatric surgery
• Congenital disorders