Congenital nasal obstruction: clinical and radiologic review

Abstract

Congenital nasal obstruction can result in neonatal respiratory distress because neonates are obligate nasal breathers. Therefore, all physicians who deal with infants should be familiar with the structural abnormalities, masses, and syndromes that cause nasal obstruction, so that appropriate work-up and treatment can be promptly initiated. This paper reviews the embryology of the nasal passage and then continues with the different causes of nasal obstruction. Special attention is paid to the presentation, physical exam findings, and imaging modality of choice.

Oropharyngeal Dermoid Cyst in an Infant with Intermittent Airway Obstruction

“…enclosed cysts. Nasal gliomas are thought to represent accumulations of dysplastic brain tissue in the nasal cavity or subcutaneous tissue and are separate from intracranial tissue 8 . Hypointense signal on T1-weighted images usually differentiates between nasal gliomas and oropharyngeal dermoid cysts.…”

Early Transient Prenatal Ultrasound Features of Choanal Atresia

“…Unilateral choanal atresia is more common than bilateral. Bilateral choanal atresia is considered an emergency condition at birth, as neonates are “obligate nasal breathers.” Thus, quick diagnosis is crucial, and immediate airway preservation is mandatory . Unilateral choanal atresia is usually manifested in infancy at the age of 5 to 10 months by persistent mucoid rhinorrhea or chronic sinusitis …”

“…The diagnosis of choanal atresia is established postnatally by the inability to pass a firm catheter through each nostril 3 to 4 cm into the nasopharynx. The atretic plate may be seen directly on with fiber‐optic rhinoscopy …”

“…Thus, quick diagnosis is crucial, and immediate airway preservation is mandatory. 3 Unilateral choanal atresia is usually manifested in infancy at the age of 5 to 10 months by persistent mucoid rhinorrhea or chronic sinusitis. 3 Associated malformations frequently present with choanal atresia and are reported in approximately 50% of cases.…”

“…3 Unilateral choanal atresia is usually manifested in infancy at the age of 5 to 10 months by persistent mucoid rhinorrhea or chronic sinusitis. 3 Associated malformations frequently present with choanal atresia and are reported in approximately 50% of cases. 4 The most common association is found with CHARGE syndrome.…”