Choanal Atresia: Causes, Symptoms, Diagnosis, Treatment, and Prevention
An unusual condition affecting newborns is choanal atresia. It occurs when a blockage of the nasal passages occurs because of bone or tissue. It can affect the nose on one or both sides, and it can be partial or complete. A congenital defect, choanal atresia is present at birth. There are numerous factors that may contribute to it, including genetics and the environment.
Causes of Choanal Atresia
It is unclear what causes choanal atresia, but genetics and heredity may play a role. An individual with choanal atresia does not disappear the thin tissue that separates the nose and mouth area during fetal development after birth. After birth, this tissue blocks the nasal passages, causing problems.
In addition to choanal atresia, there is also a genetic disorder called CHARGE syndrome that affects various organs and functions of the body. CHARGE stands for coloboma (a congenital eye condition that impairs vision), heart defects, choanal atresia (another term for choanal atresia), growth retardation, genital abnormalities, and ear abnormalities. The symptoms of CHARGE syndrome can vary from person to individual.
Choanal atresia may also be increased by certain environmental factors, such as exposure to certain chemicals or medications during pregnancy. A study, for example, found that women living in regions with high concentrations of atrazine, a chemical compound used in herbicides, were more likely to develop choanal atresia.
Symptoms of Choanal Atresia
The symptoms of choanal atresia depend on the type and severity of the condition. There are two types of choanal atresia:
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A unilateral choanal atresia affects only one side of the nose. The symptoms are often mild or absent, as the baby is able to breathe through the other side.
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Chronic nasal congestion or discharge on one side of the nose
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Difficulty feeding or swallowing
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Snoring or noisy breathing
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Recurrent sinus infections or ear infections
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Reduced sense of smell
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This is the less common but more serious type of choanal atresia, which affects both sides of the nose. Symptoms usually include the baby not being able to breathe through their nose at all.
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Difficulty breathing or respiratory distress at birth
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Bluish discoloration of the skin or lips (cyanosis) due to lack of oxygen
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Breathing only through the mouth or when crying
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Difficulty feeding or gaining weight
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Dehydration or dry mouth
Diagnosis of Choanal Atresia
When a baby has bilateral choanal atresia and shows signs of breathing difficulties, choanal atresia is usually diagnosed shortly after birth. In addition to a physical exam of the nose and throat, imaging tests such as X-rays, CT scans, and MRI scans can be used to confirm the diagnosis. A blockage can be located, measured, and assessed to determine whether it is bone or tissue in nature.
When a baby has unilateral choanal atresia and mild or no symptoms, choanal atresia may be diagnosed later in childhood or adulthood and confirmed by the same tests.
Treatment of Choanal Atresia
Choanal atresia is treated based on the type and severity of the condition as well as the patient's age and health. The main goal is to restore normal breathing through the nose and prevent complications like infections or growth problems.
The treatment options for choanal atresia include:
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As the most common and effective treatment for choanal atresia, surgery involves removing the bone or tissue blocking the nasal passages and creating a clear passage. Depending on the location and extent of the blockage, surgery can be performed either through the nose (endoscopic surgery) or through the mouth (transpalatal surgery). For patients with unilateral choanal atresia or mild symptoms, surgery can improve breathing, feeding, and quality of life. Surgery can be done soon after birth for babies with bilateral choanal atresia, or later in childhood or adulthood for patients with unilateral choanal atresia or mild symptoms.
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Stents or tubes: These devices are inserted into the nasal passages after surgery to keep them open and prevent scarring or narrowing. Stents or tubes are usually left in place for a few weeks or months, and then removed by the doctor. These devices are helpful in preventing choanal atresia recurrence and improving surgery outcomes.
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Medications: These are drugs that are given to patients with choanal atresia to relieve symptoms such as congestion, inflammation, or infection. In addition to nasal sprays, decongestants, antihistamines, steroids, and antibiotics, medications can also be used as an alternative to surgery when symptoms are mild or nonexistent.
Prevention of Choanal Atresia
There is no sure way to prevent choanal atresia, as the causes are not fully known. However, some possible preventive measures include:
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Avoiding exposure to harmful chemicals or medications during pregnancy, such as herbicides, alcohol, tobacco, or certain drugs that can affect fetal development
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Seeking genetic counseling or testing if there is a family history of choanal atresia or CHARGE syndrome, or if the mother has a genetic disorder that can increase the risk of choanal atresia
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Having regular prenatal check-ups and ultrasounds to monitor the growth and development of the baby, and to detect any abnormalities in the nose or other organs
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Seeking immediate medical attention if the baby shows signs of breathing difficulty or cyanosis at birth, or if the child has chronic nasal problems or infections
Summary
As a result of a blockage of the nasal passages by bone or tissue, Choanal atresia affects newborns in a rare way. There are two types of choanal atresia: partial and complete. A choanal atresia is a congenital defect, meaning it is present at birth. It can affect one side or both sides of the nose. Environmental, genetic, or a combination of factors can cause this condition.
Depending on its type and severity, choanal atresia can cause a variety of symptoms. Symptoms can range from mild nasal congestion or discharge to severe breathing problems or cyanosis. A physical examination and imaging tests, including X-rays, CT scans, or MRI scans, can be used to diagnose choanal atresia.
Choanal atresia can be treated in a number of ways, depending on its type and severity, as well as the patient's age and health. The main goal of treatment is to restore normal breathing through the nose and prevent complications. There are several options for treating this condition, including surgery, stents and tubes, and medications. By avoiding exposure to harmful chemicals or medications during pregnancy, seeking genetic counseling or testing, receiving regular prenatal check-ups and ultrasounds, and seeking immediate medical attention if the baby or child has breathing or nasal problems, you can prevent choanal atresia.
With proper diagnosis and treatment, patients with choanal atresia can breathe normally and live a healthy and happy life.
