It is the congenital unilateral or bilateral closure of the area between the nasal cavity and the nasopharynx. This area, which should normally be open during childbirth, can sometimes remain closed in the form of a thin membrane structure and sometimes rigidly in the form of a bone structure. Choanal atresia can be alone or sometimes in combination with other congenital disorders. Such as face, nose and palate problems, congenital heart diseases, eye diseases, ear problems, finger abnormalities, esophagus and trachea problems… Therefore, the patients should also be evaluated by other related branches such as genetics, cardiology, eye diseases etc.
What are the symptoms in choanal atresia?
Newborns must breathe through the nose after birth and therefore their nostrils must be open. Especially bilateral choanal atresia can be life-threatening and requires immediate intervention. It is manifested by respiratory distress and bruising, which often occurs immediately after birth in infants, which increases during sucking and decreases with crying. These problems are more common in cases of bilateral choanal atresia.
How to detect choanal atresia in a baby?
If postnatal choanal atresia symptoms are observed in the baby, a catheter is sent from both nostrils during the first examination to see if it goes down to the oral cavity. If the catheter does not pass, it is suspected that the nostrils are closed. Another method is to detect the presence of obstruction by checking both nostrils with a fiberoptic flexible endoscope. Apart from these, it is possible to see closed nostrils by taking computerized tomography.
How is choanal atresia treated?
When there is unilateral atresia, emergency treatment is usually not required and the baby can be expected to grow in order to open the obstruction with surgery. Bilateral occlusions require immediate intervention, and airway patency and nutritional support must be provided in the first place. Temporary methods such as placing a tube to facilitate mouth breathing, intubation or, rarely, opening a tracheotomy, may be used to initially open the airway. However, the main treatment method is to open the clogged area with surgery. For this purpose, we can use intraoral intervention, intranasal intervention, unblocking with laser, and endoscopic approach that it is the most used method today. During these interventions, a temporary stent can be placed in the nose to prevent reclosure.
