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DefinitionChoanal atresia is a narrowing or blockage of the nasal airway by membranous or bony tissue. It is a congenital condition, meaning it is present at birth.
Causes, incidence, and risk factors
The cause of choanal atresia is unknown, but is thought to result from persistence of the membrane between the nasal and oral spaces during fetal development. The condition is the most common nasal abnormality seen in the newborn infant, affecting about 1 in 7,000 live births. Choanal atresia may be either on one side or on both sides and is often associated (in about 50% of cases) with other congenital abnormalities.
The newborn is what is known as an "obligate nose breather," meaning it must breathe through its nose because its oral airway is not yet developed enough to allow for frequent mouth breathing. In fact, almost the only time an infant does not breathe through its nose is when crying.
Choanal atresia blocking both sides (bilateral) of the nose causes acute breathing problems with cyanosis and breathing failure. Infants with bilateral choanal atresia may need resuscitation at delivery.
Blockage on only one side causes less severe problems. Choanal atresia is generally recognized shortly after birth while the infant is still in the hospital.
Signs and tests
The immediate concern is to resuscitate the baby if necessary. An airway may need to be placed so that the infant can breathe. In some cases, intubation or tracheostomy may be needed.
An infant can learn to mouth breathe, which can delay the need for immediate surgery.
Surgery to remove the obstruction cures the problem. It may be delayed if the infant can tolerate mouth breathing. Possible surgical approaches include through the nose (transnasal) and through the mouth (transpalatal).
Expectations (prognosis)Full recovery is expected.
ComplicationsPossible complications include:
Calling your health care providerChoanal atresia, especially when it affects both sides, is generally diagnosed shortly after birth while the infant is still in the hospital. One-sided atresia may be relatively symptom-free, and these infants may be sent home without a diagnosis. If your infant exhibits any of the problems listed here, consult your health care provider.
PreventionBecause the cause is unknown, prevention is unknown.
Update Date: 11/4/2003Grace Jeon, M.D.,M.P.H., General Surgeon, Pasadena, CA. Review provided by VeriMed Healthcare Network.
Last updated: Tue, 06 Jan 2009 00:20:03 GMT