Choanal Atresia

Excerpt

First described in 1755 by Johann Roderer, choanal atresia is a disorder characterized by the congenital absence of the nasal choanae, the paired openings that connect the nasal cavity with the nasopharynx (see Image. Choanal Atresia on Nasal Endoscopy). This condition stems from the failure of nasopharyngeal recanalization during fetal development and can involve soft tissue, bone, or both. Choanal atresia may be complete, lacking communication between the nasal cavity and nasopharynx, or partial, with only choanal stenosis.

Unilateral atresia often presents with unilateral mucopurulent discharge but may not be clinically evident until the child is older if they can breathe through the contralateral side. Bilateral atresia manifests in neonates as respiratory distress immediately after birth due to the inability to breathe, as newborns are obligate nasal breathers. Bilateral choanal atresia is an acute otolaryngologic emergency warranting immediate airway management.