Neonatology Book

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Choanal Atresia

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  1. Definition
    1. Complete obstruction of one or both nares
  2. Pathophysiology
    1. Infants are obligate nose breathers until 4 months old
  3. Signs
    1. Bilateral Choanal atresia
      1. Cyanosis that is relieved with crying
    2. Unilateral Choanal atresia
      1. Diagnosis usually delayed by years
      2. Foul mucus discharge from affected naris
      3. Upper Respiratory Infection may result in distress
  4. Diagnosis
    1. Check patency with stethoscope (listen over nares)
    2. Small feeding tube unable to pass via naris
      1. Lubricate 5 french tube
      2. Normally should meet no resistance
  5. Management: Bilateral Choanal Atresia
    1. Bilateral Choanal Atresia in newborn is an emergency
    2. Stabilization
      1. Oral Airway
    3. Surgical repair
      1. Laser burrowing of bony palate
  6. References
    1. Cloherty (1991) Neonatal Care, Little Brown, p. 501
    2. Fuloria (2002) Am Fam Physician 65(1):61

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