What is Bilateral Choanal Atresia?
Bilateral choanal atresia is a congenital condition where the back of the nasal passage is blocked, usually by abnormal bony or soft tissue, which prevents normal breathing through the nose. This condition is particularly critical in newborns who are obligate nasal breathers.
What are the Symptoms?
Newborns with bilateral choanal atresia may present with severe respiratory distress immediately after birth. Symptoms include cyanosis, difficulty breathing, and an inability to feed properly due to breathing difficulties. These symptoms often improve when the infant cries, as mouth breathing is then possible.
How is it Diagnosed?
Diagnosis is often made clinically by the inability to pass a catheter through the nostrils into the throat. Confirmation can be obtained through imaging techniques such as a CT scan, which provides detailed images of the nasal passages and reveals the extent and nature of the atresia.
What are the Causes?
The exact cause of choanal atresia is not entirely understood, but it is believed to result from improper development during fetal growth. It can occur as an isolated anomaly or as part of a syndrome, such as CHARGE syndrome, which involves multiple congenital anomalies.
What are the Treatment Options?
The primary treatment for bilateral choanal atresia is surgical intervention. The goal of surgery is to create a patent airway. Techniques may include transnasal endoscopic surgery or using a stent to keep the nasal passage open post-surgery. Immediate stabilization of the airway is crucial, and temporary solutions such as an oral airway or intubation might be needed.
What is the Prognosis?
With timely surgical intervention, the prognosis for infants with bilateral choanal atresia is generally good. However, ongoing follow-up is necessary to monitor for potential complications or recurrence of the blockage.
Can it be Prevented?
As a congenital condition, there are no specific preventative measures for choanal atresia. However, early detection and intervention can manage the symptoms effectively and improve the outcome for affected infants.
What is the Role of a Pediatrician?
A pediatrician plays a crucial role in the early identification and management of bilateral choanal atresia. They coordinate with specialists such as pediatric ENT surgeons to ensure timely and appropriate treatment. Additionally, pediatricians provide ongoing care and support to the family, addressing any complications that may arise.
Are there any Long-Term Concerns?
While most children recover well post-surgery, there can be long-term concerns such as recurring blockages, nasal discharge, or the need for additional surgeries. Regular follow-ups with healthcare providers are essential to monitor the child’s development and address any issues promptly.
