Anterior Nares Deformity
Dermoid Cysts
MRI for any congenital massZ
Meningo and Encephaloceles
Choanal Atresia
Choanal Atresia
- Due to persistence of the primitive bucconasal membrane
- Unilateral or bilateral
- Bony, membranous or mixed
Unilateral Choanal Atresia
- Usually diagnosed late in life
- Presents by unilateral nasal obstruction and unilateral mucoid nasal discharge
- Treatment is by elective surgical repair
#OSPE
improves with crying
Bilateral Choanal Atresia
-
Isolated anomaly in 60-70%
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May be linked to CHARGE association
- Heart disease
- Atresia
- Retarded growth
- Genital hypoplasia
- Ear deformity
-
Usually presents at birth by attacks of cyclic cyanosis and respiratory obstruction
-
Nasal discharge
Diagnosis
- Clinical examination: “mirror test”
- Inability to pass a catheter into the nasopharynx
- Endoscopy
- Radiographs
Management
A) Emergency
- Immediate airway support with oral airway, McGovern nipple, or intubation
B) Definitive SurgeryZ
C) Surgical Approaches to the ChoanaY
- Transnasal
- Transpalatal
- Transseptal
- Lateral rhinotomy
- External rhinoplasty