Congenital bilateral choanal atresia

Area of Science:

• Otolaryngology
• Pediatric Surgery
• Neonatology

Background:

• Congenital choanal atresia (CCA) is a congenital malformation characterized by the failure of the posterior nasal cavity to communicate with the nasopharynx.
• Bilateral CCA presents as a life-threatening emergency in newborns, necessitating prompt diagnosis and management.
• Early surgical intervention is crucial for bilateral cases to prevent severe respiratory compromise.

Observation:

• A full-term, healthy newborn presented with recurrent episodes of cyanosis and respiratory distress shortly after birth.
• Clinical examination revealed alternating cyanosis and normal coloration, suggestive of an airway obstruction.
• Diagnostic confirmation of bilateral CCA was achieved through the unsuccessful insertion of nasal catheters into both nares.

Findings:

• The case highlights a rare instance of bilateral congenital choanal atresia in an otherwise healthy neonate.
• Conservative management was initially employed, followed by elective transnasal endoscopic repair on the tenth day of life.
• The endoscopic approach successfully relieved the life-threatening nasal obstruction.

Implications:

• This case underscores the importance of early recognition of congenital choanal atresia in neonates presenting with respiratory distress.
• Transnasal endoscopic repair is an effective and minimally invasive surgical option for correcting bilateral CCA.
• Timely surgical intervention in neonates with bilateral CCA significantly improves outcomes and prevents mortality.