What is Choanal Atresia in Children?

Choanal atresia is a congenital condition where the back of the nasal passage is narrowed or blocked, making breathing difficult. It occurs due to abnormal development of the soft tissues and bones that separate the nose, throat, and mouth. Although rare (1 in 7,000 births), it is the most common nasal abnormality in newborns and affects girls more frequently than boys.

There are two types of choanal atresia:

Unilateral choanal atresia: One nostril is blocked. It is more common and may go unnoticed until later in life.
Bilateral choanal atresia: Both nostrils are blocked. Since infants breathe mainly through the nose, this can be life-threatening and requires immediate medical attention.

Choanal atresia is often associated with other developmental conditions such as Tessier cleft, CHARGE syndrome, or Treacher Collins syndrome. Genetic testing is recommended in such cases.

What are the signs and symptoms of choanal atresia in children?

Difficulty breathing that improves while crying
Noisy breathing
Trouble feeding
Persistent nasal discharge
Inability to pass a suction tube through the nostril during examination

Why does choanal atresia occur?

The exact cause of choanal atresia is unknown. It is believed to result from the failure of tissue between the nose and mouth to properly recede during fetal development.

What are the complications associated with this condition?

Untreated choanal atresia can lead to chronic complications, such as:

Fluid buildup in the nasal passage
Frequent ear infections
Hearing loss (especially in CHARGE syndrome)
Feeding difficulties and risk of aspiration (food entering the windpipe)

How is choanal atresia diagnosed in children?

Diagnosis is usually made at birth, particularly in bilateral cases. A doctor may use a laryngeal mirror to check for airflow through the nostrils. Diagnostic tests include:

CT scan: Provides detailed images of nasal structure and blockages
Nasal endoscopy: A small camera is inserted into the nose to view internal anatomy

Supportive breathing assistance is provided during testing to ensure the baby's safety.

How is choanal atresia treated in children?

Surgery is the only definitive treatment for choanal atresia. The timing and urgency depend on the severity of the condition:

Surgery

Surgical options involve creating an opening in the obstructed nasal passage via either a transnasal or transpalatal approach. A stent may be inserted to keep the airway open during healing and is removed later by the surgeon. The surgery is performed under general anesthesia in an operating room.

Management

In unilateral cases with no severe symptoms, surgery can be delayed. Meanwhile, symptoms may be managed at home with medical guidance. For instance, saline rinses help maintain clear nasal passages.

What can I expect if my baby has choanal atresia?

Your doctor will walk you through treatment options. Surgery generally offers successful outcomes, and most children recover completely. In unilateral cases, your doctor will advise when surgery is necessary and what warning signs to monitor.

When should I call my child’s doctor?

Contact your child’s doctor if you notice any changes in their breathing or feeding habits. In unilateral cases, symptoms may not appear until later, so early evaluation is essential if concerns arise.

Why Choose Tender Palm Super-Speciality Hospital for Choanal Atresia Treatment in Children in Lucknow, India?

Tender Palm Super-Speciality Hospital has the most trusted team of Pediatric ENT specialists and surgeons with advanced diagnostic equipment and child-friendly care for Pediatric Choanal Atresia treatment in Lucknow, India. Our Pediatric ENT department follows international safety standards and has years of experience in successfully managing children's ear, nose and throat diseases.