Congenital choanal atresia: computed tomographic and clinical findings

Congenital choanal atresia is a rare developmental anomaly characterized by failure of communication of the posterior nasal cavity with the nasopharynx. It may present as a component of the CHARGE association (C, coloboma; H, heart disease; A, atresia choanae; R, retarded growth and development; G, genital hypoplasia; and E, ear anomalies and/or deafness). The purpose of this study is to evaluate the computed tomographic (CT) appearance of membranous or bony type congenital choanal atresia. Six patients (4 females, 2 males; age range, 1 day to 8 weeks; mean, 13.8 days) with choanal atresia were included in this study and evaluated by CT scan. The CT clearly delineated the full anatomic abnormalities of choanal atresia. Among the 6 patients, three (50%) had bilateral membranous atresia, two (33%) had bilateral bony atresia, and one (17%) had unilateral (left) membranous atresia. Additionally, two (33%) patients (1 bilateral membranous atresia, 1 bilateral bony atresia) fit at least four of the six criteria in the CHARGE association. The CT plays a significant role in the diagnostic and therapeutic approach to congenital choanal atresia and should be the examination method of choice to evaluate neonates with nasal obstruction.