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Joseph Junewick, MD FACR
over 7 years ago
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Bilateral Choanal Atresia

Case Detail

Anatomy: Neck-Face
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Developmental or Congenital
Created: over 4 years ago
Updated: over 4 years ago
Tags: PEDS
Modality/Study Types: CT
Activities:
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History

Unable to pass enteric tube.


Case Images


Diagnosis

Bilateral Choanal Atresia

Findings

CT – Noncontrast axial and sagittal (right and left) images of the face showing marked osseous narrowing and membranous obstruction of the posterior nasal pharynx.

Discussion

Choanal atresia results from failure of resorption of the mesodermal plate that separates the stomadeum and neuroectoderm. In boney atresia, the most severe form of this condition, the hard palate and vomer are fused with the ventral clivus, resulting in a very small nasopharynx. In membranous choanal atresia, the buccopharyngeal membrane does not resorb. In most cases, there is a combination of boney and membranous types. Choanal atresia occurs in one of 8000 live births and is commonly associated with syndromes (eg, CHARGE, synostosis) . Approximately two-thirds of cases are bilateral. Affected newborns experience respiratory distress because they are obligatory nasal breathers. The imaging method of choice for suspected choanal anomalies is volumetric CT with high spatial frequency algorithm and optimized reconstruction planes. Normal choanal orifices measure more than 0.37 cm in children younger than 2 years.

Reference

Valencia MP, Castillo M. Congenital and Acquired Lesions of the Nasal Septum: A Practical Guide for Differential Diagnosis. Radiographics (2008); 28:205-223.



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