Choanal atresia

From Wikipedia, the free encyclopedia

Choanal atresia
Classification and external resources

Specialty

medical genetics

ICD-10

Q30.0

ICD-9-CM

748.0

OMIM

608911

DiseasesDB

31330

MedlinePlus

001642

eMedicine

ent/330

[edit on Wikidata]

Choanal atresia is a congenital disorder where the back of the nasal passage (choana) is
blocked, usually by abnormal bony or soft tissue (membranous) due to failed recanalization of
the nasal fossae during fetal development.
Contents
[hide]

1Presentation

2Associated conditions

3Diagnosis

4Risk factors

5Treatment

6References

7External links

Presentation[edit]

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
mainly 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[edit]
Sometimes babies born with choanal atresia also have other abnormalities:

coloboma

heart defects

mental retardation

growth impairment

others (see also CHARGE syndrome)

Also any condition that causes significant depression of the nasal bridge or midface retraction
can be associated with choanal atresia. Examples include the craniosynostosissyndromes such
as Crouzon syndrome, Pfeiffer syndrome, and Antley-Bixler syndrome.

Diagnosis[edit]
Choanal atresia can be suspected if it is impossible to insert a nasal catheter.[1] Also, if one
notices a continuous stream of mucus draining from one or both nostrils, it could be a sign of an
atresia. Another common sign is cyanosis in an infant while breast feeding, as breathing is
dependent on nasal patency in this situation.[1] Diagnosis is confirmed byradiological imaging,
usually CT scan.[1]

Risk factors[edit]
Very few risk factors for choanal atresia have been identified. While causes are unknown, both
genetic and environmental triggers are suspected. [2] One study suggests that chemicals that act
as endocrine disrupters may put an unborn infant at risk. A 2012 epidemiological study looked
at atrazine, a commonly used herbicide in the U.S., and found that women who lived in counties
in Texas with the highest levels of this chemical being used to treat agricultural crops were 80
times more likely to give birth to infants with choanal atresia or stenosis compared to women who
lived in the counties with the lowest levels.[3] Another epidemiological report in 2010 found even
higher associations between increased incidents of choanal atresia and exposure to secondhand-smoke, coffee consumption, high maternal zinc and B-12 intake and exposure to antiinfective urinary tract medications.[4]

Treatment[edit]
Temporary alleviation can be achieved by inserting an oral airway into the mouth. However, the
only definitive treatment is surgery to correct the defect by perforating the atresia to create a

nasopharyngeal airway. If the blockage is caused by bone, this is drilled through and stent
inserted. The patient has to have this sucked out by an air vacuum machine . And in later life as
a teenager or in early twenties the hole will have to be re-drilled larger.
A stent may be inserted[5] to keep the newly formed airway patent or repeated dilatation may be
performed.[6]