Choanal Atresia: Birth Without Breath

Sinha, Vikas; Umesh, Samanth Talagauara; Jha, Sushil G.; Dadhich, Swati

doi:10.1007/s12070-017-1220-4

Cited by 4 publications

(9 citation statements)

References 17 publications

(17 reference statements)

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Section: Discussionmentioning

confidence: 99%

“…Infants are obligate nasal breathers because the oral airway is invariably blocked during calm respiration [ 11 ]. Infants breathe through the mouth only during crying, and infants have only nasal breathing until 5 months of life [ 11 ]. A one-third reduction in the diameter of the nasal airway can increase nasal airway resistance 81-fold, resulting in severe distress in neonates [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

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Successful Noninvasive Respiratory Management of an Infant with Bilateral Choanal Atresia and a Supernumerary Nostril Located on the Columella by a Mouthpiece: A Case Report

et al. 2023

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Patient: Female, Newborn Final Diagnosis: Bilateral choanal atresia and a supernumerary nostril located on the columella Symptoms: Respiratory distress Clinical Procedure: — Specialty: Pediatrics and Neonatology Objective: Rare disease Background: Choanal atresia with a supernumerary nostril located on the columella is extremely rare. Infants are obligate nasal breathers because the oral airway is invariably blocked during calm respiration. Infants breathe through the mouth only during crying, and they only have nasal breathing until 5 months of life. Congenital nasal anomalies have been reported to be fatal from birth, requiring tracheal intubation or tracheostomy in the early post-natal period. In these cases, it is crucial to maintain an adequate airway. Case Report: A 2948-g female infant was born at 40 weeks by normal vaginal delivery. Her Apgar scores were 9 and 9 at 1 and 5 min, respectively. She had retractive breathing, cyanosis, and a supernumerary nostril at birth. She had no other anomalies. Computed tomography showed bilateral membranous choanal atresia. She needed nasal continuous positive pressure or a high-flow nasal canula for oxygen desaturation during crying, apnea, and dyspnea. However, her respiratory symptoms did not improve completely. On day 25 of life, she was given a mouthpiece to support mouth breathing. Her respiratory symptoms improved gradually, and she was discharged on day 73 of life with a mouthpiece. Conclusions: A very rare case of choanal atresia with a supernumerary nostril located on the columella was described. A mouthpiece was effective for breathing, obviating the need for emergency surgical intervention in the early postnatal period. Emergency procedures were avoided, probably because this case involved incomplete bilateral membranous choanal atresia rather than complete bony atresia.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Successful Noninvasive Respiratory Management of an Infant with Bilateral Choanal Atresia and a Supernumerary Nostril Located on the Columella by a Mouthpiece: A Case Report

et al. 2023

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“…The results are hardly comparable, given the several surgical approaches included in the series [13,14,24]. More recent studies have described cases treated only with the endoscopic technique [15][16][17][18]. Schraff et al first compared postoperative outcomes in 14 CHARGE patients (nine with bilateral CA and five with unilateral CA), treated via transnasal (10 cases) or transpalatal (four cases) approaches.…”

Section: Discussionmentioning

confidence: 99%

“…In their experience, CHARGE association had a very unsolicited outcome. All CHARGE patients (eight cases) died 5-10 days after surgery due to complications of the syndrome [15]. A recent Italian multicentric study included 84 patients with CA.…”

Section: Discussionmentioning

confidence: 99%

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Bilateral Choanal Atresia and Endoscopic Surgery: A Chance for CHARGE Patients

Baldovin

Cazzador

Zanotti

et al. 2021

JCM

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Bilateral choanal atresia (CA) is a rare congenital malformation frequently associated with other anomalies. CHARGE association is closely linked to bilateral CA. The aim of this study was to describe the outcomes of the endoscopic repair in bilateral CA, and to assess the role of postoperative nasal stenting in two cohorts of CHARGE-associated and non-syndromic CA. Thirty-nine children were retrospectively analyzed (16 patients had CHARGE-associated CA). The rate of postoperative neochoanal restenosis was 31.3% in the CHARGE population, and 47.8% in the non-syndromic CA cohort. Data on postoperative synechiae and granulation tissue formation, need for endonasal toilette and dilation procedures, and number of procedures per patient were presented. Stent positioning led to a higher number of postoperative dilation procedures per patient in the non-syndromic cohort (p = 0.018), and to a higher rate of restenosis both in the CHARGE-associated, and non-syndromic CA populations. Children with CHARGE-associated and non-syndromic bilateral CA benefitted from endonasal endoscopic CA correction. The postoperative application of an endonasal stent should be carefully evaluated.

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Bilateral choanal atresia diagnosed in a 3-month-old female baby: a case report

Abraham

Kahinga

2023

Annals of Medicine &Amp; Surgery

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Introduction and Importance: Bilateral choanal atresia is a congenital anomaly where a newborn baby is born with bilateral imperforate posterior nares. In most cases, the diagnosis is established immediately after birth due to respiratory distress since newborn babies are obligate nasal breathers till 6 weeks of life. Establishing the diagnosis requires a high index of suspicion as it is characterized by paradoxical cyclical cyanosis. Delayed diagnosis of bilateral choanal atresia is a rare encounter in clinical practice. We are hereby reporting a 3-month-old baby with bilateral choanal atresia, and perhaps it is the third latest diagnosed case of bilateral choanal atresia in Tanzania. Case Presentation: We present a 3-month-old female baby who was attended to at our department with a history of difficulty in breathing characterized by bilateral nasal obstruction since birth. The baby was admitted for 3 weeks due to episodes of respiratory distress after birth. She was thereafter discharged from the hospital and attended various hospitals without relief since the baby was managed as a case of adenoid hypertrophy. Clinical Discussion: The patient underwent bilateral transnasal endoscopic choanal atresia release with stenting under general anesthesia in the operating room. Postoperatively, she was kept on a nasal decongestant, a broad-spectrum antibiotic, and an analgesic. Regular suctioning was done during routine follow-up. Conclusion: Clinicians must have a high index of suspicion to establish the diagnosis of bilateral choanal atresia in newborn babies. Immediate surgical perforation of the atretic choanae with or without stenting remains to be the treatment of choice.

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Choanal Atresia: Birth Without Breath

Cited by 4 publications

References 17 publications

Successful Noninvasive Respiratory Management of an Infant with Bilateral Choanal Atresia and a Supernumerary Nostril Located on the Columella by a Mouthpiece: A Case Report

Successful Noninvasive Respiratory Management of an Infant with Bilateral Choanal Atresia and a Supernumerary Nostril Located on the Columella by a Mouthpiece: A Case Report

Bilateral Choanal Atresia and Endoscopic Surgery: A Chance for CHARGE Patients

Bilateral choanal atresia diagnosed in a 3-month-old female baby: a case report

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