Choanal atresia - Revision history

Rossdonaldson1: /* Management */

2020-12-12T11:32:23Z

Management

← Older revision		Revision as of 11:32, 12 December 2020
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	*Bilateral		*Bilateral
	**If presenting with respiratory distress, individuals require immediate airway management, either with an oral airway or endotracheal intubation <ref> Andaloro, C. and Mantia, I., 2020. Choanal Atresia. [online] Ncbi.nlm.nih.gov. Available at: <https://www.ncbi.nlm.nih.gov/books/NBK507724/> </ref>		**If presenting with respiratory distress, individuals require immediate airway management, either with an oral airway or endotracheal intubation <ref> Andaloro, C. and Mantia, I., 2020. Choanal Atresia. [online] Ncbi.nlm.nih.gov. Available at: <https://www.ncbi.nlm.nih.gov/books/NBK507724/> </ref>
	*Definitive management is surgical repair		**Definitive management is surgical repair

	==Disposition==		==Disposition==

Rossdonaldson1: /* Management */

2020-12-12T11:32:04Z

Management

← Older revision		Revision as of 11:32, 12 December 2020
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	==Management==		==Management==
	*Unilateral ~~- generally~~ does not require emergent surgical repair, but respiratory status should be carefully considered. Nasal saline can be helpful for keeping the nasal route clear		*Unilateral
	*Bilateral ~~- if~~ presenting with respiratory distress, individuals require immediate airway management, either with an oral airway or endotracheal intubation <ref> Andaloro, C. and Mantia, I., 2020. Choanal Atresia. [online] Ncbi.nlm.nih.gov. Available at: <https://www.ncbi.nlm.nih.gov/books/NBK507724/> </ref>		**Generally does not require emergent surgical repair, but respiratory status should be carefully considered.
			**Nasal saline can be helpful for keeping the nasal route clear
			*Bilateral
			**If presenting with respiratory distress, individuals require immediate airway management, either with an oral airway or endotracheal intubation <ref> Andaloro, C. and Mantia, I., 2020. Choanal Atresia. [online] Ncbi.nlm.nih.gov. Available at: <https://www.ncbi.nlm.nih.gov/books/NBK507724/> </ref>
	*Definitive management is surgical repair		*Definitive management is surgical repair

			==Disposition==

	==See Also==		==See Also==

Rossdonaldson1: /* Background */

2020-12-12T11:30:56Z

Background

← Older revision		Revision as of 11:30, 12 December 2020
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	==Background==		==Background==
			[[File:PMC5010437 arh0011601550001.png\|thumb\|Nasal endoscopic view of posterior choanae, depicting complete atresia bilaterally.]]
	*Obliteration or blockage of the posterior nasal aperture		*Obliteration or blockage of the posterior nasal aperture
	*Incidence is between 1:5000 and 1:8000 live births		*Incidence is between 1:5000 and 1:8000 live births

Rossdonaldson1: /* Evaluation */

2020-12-12T11:27:08Z

Evaluation

← Older revision		Revision as of 11:27, 12 December 2020
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	==Evaluation==		==Evaluation==
			[[File:Membranoese Choanalatresie beidseits NG - CT axial und coronar - 001 -Annotationen.png\|thumb\|Bilateral choanal atresia on CT scan.]]
	*Examiner can attempt to pass a 5 or 6 fr catheter from the nose to the oropharynx, alternatively the examiner can use a qualitative measure of nasal airflow (i.e. the movement of a wisp of cotton under the nostrils, fogging of a mirror)		*Examiner can attempt to pass a 5 or 6 fr catheter from the nose to the oropharynx, alternatively the examiner can use a qualitative measure of nasal airflow (i.e. the movement of a wisp of cotton under the nostrils, fogging of a mirror)
	*Diagnosis is confirmed with CT imaging with intranasal contrast		*Diagnosis is confirmed with CT imaging with intranasal contrast
	*Ideally diagnosis of this condition should be done immediately after birth		*Ideally diagnosis of this condition should be done immediately after birth
	*A thorough physical exam should also be performed to detect associated anomalies		*A thorough physical exam should also be performed to detect associated anomalies

	==Management==		==Management==

Rossdonaldson1 at 11:25, 12 December 2020

2020-12-12T11:25:03Z

← Older revision		Revision as of 11:25, 12 December 2020
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	==Background==		==Background==

	*Obliteration or blockage of the posterior nasal aperture		*Obliteration or blockage of the posterior nasal aperture
	*Incidence is between 1:5000 and 1:8000 live births		*Incidence is between 1:5000 and 1:8000 live births
Line 42:		Line 41:
	*Bilateral - if presenting with respiratory distress, individuals require immediate airway management, either with an oral airway or endotracheal intubation <ref> Andaloro, C. and Mantia, I., 2020. Choanal Atresia. [online] Ncbi.nlm.nih.gov. Available at: <https://www.ncbi.nlm.nih.gov/books/NBK507724/> </ref>		*Bilateral - if presenting with respiratory distress, individuals require immediate airway management, either with an oral airway or endotracheal intubation <ref> Andaloro, C. and Mantia, I., 2020. Choanal Atresia. [online] Ncbi.nlm.nih.gov. Available at: <https://www.ncbi.nlm.nih.gov/books/NBK507724/> </ref>
	*Definitive management is surgical repair		*Definitive management is surgical repair

			==See Also==

			==External Links==

	==References==		==References==
			<references/>

	~~<references/>~~		[[Category:Pediatrics]]
			[[Category:ENT]]

SeanDenny: /* Management */

2020-12-09T21:54:47Z

Management

← Older revision		Revision as of 21:54, 9 December 2020
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	==Management==		==Management==
	*Unilateral - generally does not require emergent surgical repair, but respiratory status should be carefully considered. Nasal saline can be helpful for keeping the nasal route clear		*Unilateral - generally does not require emergent surgical repair, but respiratory status should be carefully considered. Nasal saline can be helpful for keeping the nasal route clear
	*Bilateral - if presenting with respiratory distress, individuals require immediate airway management, either with an oral airway or endotracheal intubation		*Bilateral - if presenting with respiratory distress, individuals require immediate airway management, either with an oral airway or endotracheal intubation <ref> Andaloro, C. and Mantia, I., 2020. Choanal Atresia. [online] Ncbi.nlm.nih.gov. Available at: <https://www.ncbi.nlm.nih.gov/books/NBK507724/> </ref>
	*Definitive management is surgical repair		*Definitive management is surgical repair

SeanDenny: /* References */

2020-12-09T21:54:22Z

References

← Older revision		Revision as of 21:54, 9 December 2020
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	==References==		==References==
	~~Andaloro, C. and Mantia, I., 2020. Choanal Atresia. [online] Ncbi.nlm.nih.gov. Available at: <https://www.ncbi.nlm.nih.gov/books/NBK507724/>~~
	<references/>		<references/>

SeanDenny: /* Management */

2020-12-09T21:53:58Z

Management

← Older revision		Revision as of 21:53, 9 December 2020
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	==Management==		==Management==
	*Unilateral - generally does not require emergent surgical repair, but respiratory status should be carefully considered. Nasal saline can be helpful for keeping the nasal route clear		*Unilateral - generally does not require emergent surgical repair, but respiratory status should be carefully considered. Nasal saline can be helpful for keeping the nasal route clear
	*Bilateral - if presenting with respiratory distress, individuals require immediate airway management, either with an oral airway or endotracheal intubation ~~(book)~~		*Bilateral - if presenting with respiratory distress, individuals require immediate airway management, either with an oral airway or endotracheal intubation
	*Definitive management is surgical repair		*Definitive management is surgical repair

SeanDenny: /* Differential Diagnosis */

2020-12-09T21:45:03Z

Differential Diagnosis

← Older revision		Revision as of 21:45, 9 December 2020
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	*Deviated or dislocated nasal septum		*Deviated or dislocated nasal septum
	*~~Hematoma~~		*[[Nasal septal hematoma]]
	*~~Antrochoanal~~ polyp		*[[Nasal polyp]]
	*Chordoma		*Chordoma
	*Isolated piriform aperture stenosis		*Isolated piriform aperture stenosis

SeanDenny: Choanal Atresia

2020-12-09T02:54:31Z

Choanal Atresia

New page

==Background==

*Obliteration or blockage of the posterior nasal aperture
*Incidence is between 1:5000 and 1:8000 live births
*Approximately 60% of cases are unilateral
*More common in girls than in boys

==Clinical Features==

*Clinical presentation will depend on if unilateral or bilateral
*Unilateral
**Typically present later in life
**Commonly with purulent nasal discharge and obstruction on the affected side and/or a history of chronic sinusitis
** Rarely will present with respiratory distress

*Bilateral
**Typically will present in early life with episodes of acute respiratory distress with cyanosis that is relieved with crying and with the return of cyanosis with rest (paradoxical cyanosis)
**May present with feeding difficulty, as they are unable to breathe and feed simultaneously

*May be an isolated anomaly or associated with a congenital anomaly syndrome (e.g. Treacher-Collins, CHARGE, VACTERL/VATER, Pfeiffer)
*Other congenital anomalies are in present in 50% of individuals with unilateral choanal atresia and 60% of individuals with bilateral choanal atresia

==Differential Diagnosis==

*Deviated or dislocated nasal septum
*Hematoma
*Antrochoanal polyp
*Chordoma
*Isolated piriform aperture stenosis
*Nasal dermoid
*Nasolacrimal duct cyst
*Turbinate hypertrophy

==Evaluation==
*Examiner can attempt to pass a 5 or 6 fr catheter from the nose to the oropharynx, alternatively the examiner can use a qualitative measure of nasal airflow (i.e. the movement of a wisp of cotton under the nostrils, fogging of a mirror)
*Diagnosis is confirmed with CT imaging with intranasal contrast
*Ideally diagnosis of this condition should be done immediately after birth
*A thorough physical exam should also be performed to detect associated anomalies

==Management==
*Unilateral - generally does not require emergent surgical repair, but respiratory status should be carefully considered. Nasal saline can be helpful for keeping the nasal route clear
*Bilateral - if presenting with respiratory distress, individuals require immediate airway management, either with an oral airway or endotracheal intubation (book)
*Definitive management is surgical repair

==References==
Andaloro, C. and Mantia, I., 2020. Choanal Atresia. [online] Ncbi.nlm.nih.gov. Available at: <https://www.ncbi.nlm.nih.gov/books/NBK507724/>
<references/>