Description, Causes and Risk Factors:
Atresia due to congenital failure of one or both choanae to open owing to the failure of the bucconasal membrane to involute. It results in nasal obstruction and creates an emergency in Newborns since they are obligatory nasal breathers.
Choanal atresia is a birth defect in which the nasal passage does not properly develop during prenatal life. The cause of Choanal atresia is unknown. It is thought to occur when the thin tissue separating the nose and mouth area during fetal development remains after birth.
The condition is the most common nasal abnormality in newborn infants, affecting about 1 in 7,000 live births. There is no gender predilection. The affected infants also have other congenital problems.
Choanal atresia is generally diagnosed shortly after birth while the infant is still in the hospital.
Difficulty breathing following birth, which may result in cyanosis (bluish discoloration), unless infant is crying.
Inability to nurse and 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.
Chest retracts unless the child is breathing through mouth or crying.
There is a simple way in which a parent can check to see if their child has Choanal atresia. Hold your child up to a windowpane so that their nose is inches away from the window. As they look out to watch the birds and things, look at the pattern of mist on the windowpane caused by their breathing. Infants 8 weeks and under are obligate nose breathers and should leave a mist breathing pattern in front of their nose. If your infant is breathing through their mouth, there may be a breathing problem. If there appears to be a narrow mist pattern, check again at a later time. One side or the other may have a bit of congestion. If the pattern persist contact your Pediatrician to make sure no problems are present. A narrow or small mist pattern may indicate the nasal passage is narrow and require corrective surgery. Follow your doctor's advice on treatment recommendations.
A physical examination may show an obstruction of the nose.Tests that need be done include:
Endoscopy of the nose.
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, but physicians usually suggests nasal breathing.
Surgery to remove the obstruction cures the problem. Surgery may be delayed if the infant can tolerate mouth breathing. The surgery may be done through the nose (transnasal) or through the mouth (transpalatal).
NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.
DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.
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