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Choanal atresia

Definition:

Choanal atresia is a narrowing or blockage of the nasal airway by 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 occur when the thin tissue seperating the nasal and oral spaces during fetal development persists. The condition is the most common nasal abnormality seen in the newborn infant, affecting about 1 in 7,000 live births.

Newborns with this condition are known as an "obligate nose breathers." This means the baby must breathe through its nose because the 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 may be affect one or both sides of the nasal airway. It is often associated with other congenital problems.

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.

References:

Behrman RE. Nelson Textbook of Pediatrics. 17th ed. Philadelphia, Pa: WB Saunders; 2004.

Cummings CW, Flint PW, Haughey BH, et al. Otolaryngology: Head & Neck Surgery. 4th ed. St Louis, Mo; Mosby; 2005.

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