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Choanal Atresia
Surjith Vattoth, MD, FRCR; Bernadette L. Koch, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Definitions

                • Congenital obstruction of posterior nasal apertures
                  • Choana: Junction of posterior nasal cavity & nasopharynx
                  • Choanal atresia: Lack of communication between nasal cavity & nasopharynx

              IMAGING

              • General Features

                • CT Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Gross Pathologic & Surgical Features

                          CLINICAL ISSUES

                          • Presentation

                            • Demographics

                              • Natural History & Prognosis

                                • Treatment

                                  DIAGNOSTIC CHECKLIST

                                  • Consider

                                    • Image Interpretation Pearls

                                      • Reporting Tips

                                        Selected References

                                        1. Smith MM et al: Pediatric nasal obstruction. Otolaryngol Clin North Am. 51(5):971-85 2018
                                        2. Zawawi F et al: The pathogenesis of choanal atresia. JAMA Otolaryngol Head Neck Surg. 144(8):758-59, 2018
                                        3. Strychowsky JE et al: To stent or not to stent? a meta-analysis of endonasal congenital bilateral choanal atresia repair. Laryngoscope. 126(1):218-27, 2016
                                        4. Gangar M et al: The use of mitomycin C in pediatric airway surgery: does it work? Curr Opin Otolaryngol Head Neck Surg. 22(6):521-4, 2014
                                        5. National Organization for Rare Disorders: CHARGE syndrome. http://rarediseases.org/rare-diseases/charge-syndrome. Reviewed May 27, 2016. Accessed May 27, 2016
                                        6. Adil E et al: Congenital nasal obstruction: clinical and radiologic review. Eur J Pediatr. 171(4):641-50, 2012
                                        7. Aslan S et al: Comparison of nasal region dimensions in bilateral choanal atresia patients and normal controls: a computed tomographic analysis with clinical implications. Int J Pediatr Otorhinolaryngol. 73(2):329-35, 2009
                                        8. Burrow TA et al: Characterization of congenital anomalies in individuals with choanal atresia. Arch Otolaryngol Head Neck Surg. 135(6):543-7, 2009
                                        9. Corrales CE et al: Choanal atresia: current concepts and controversies. Curr Opin Otolaryngol Head Neck Surg. 17(6):466-70, 2009
                                        10. Ramsden JD et al: Choanal atresia and choanal stenosis. Otolaryngol Clin North Am. 42(2):339-52, x, 2009
                                        11. Hengerer AS et al: Choanal atresia: embryologic analysis and evolution of treatment, a 30-year experience. Laryngoscope. 118(5):862-6, 2008
                                        12. Samadi DS et al: Choanal atresia: a twenty-year review of medical comorbidities and surgical outcomes. Laryngoscope. 113(2):254-8, 2003
                                        13. Vanzieleghem BD et al: Imaging studies in the diagnostic workup of neonatal nasal obstruction. J Comput Assist Tomogr. 25(4):540-9, 2001
                                        14. Behar PM et al: Paranasal sinus development and choanal atresia. Arch Otolaryngol Head Neck Surg. 126(2):155-7, 2000
                                        15. Keller JL et al: Choanal atresia, CHARGE association, and congenital nasal stenosis. Otolaryngol Clin North Am. 33(6):1343-51, viii, 2000
                                        16. Black CM et al: Potential pitfalls in the work-up and diagnosis of choanal atresia. AJNR Am J Neuroradiol. 19(2):326-9, 1998
                                        17. Slovis TL et al: Choanal atresia: precise CT evaluation. Radiology. 155(2):345-8, 1985
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Imaging

                                            • Top Differential Diagnoses

                                              • Pathology

                                                • Clinical Issues

                                                  • Diagnostic Checklist

                                                    TERMINOLOGY

                                                    • Definitions

                                                      • Congenital obstruction of posterior nasal apertures
                                                        • Choana: Junction of posterior nasal cavity & nasopharynx
                                                        • Choanal atresia: Lack of communication between nasal cavity & nasopharynx

                                                    IMAGING

                                                    • General Features

                                                      • CT Findings

                                                        • Imaging Recommendations

                                                          DIFFERENTIAL DIAGNOSIS

                                                            PATHOLOGY

                                                            • General Features

                                                              • Gross Pathologic & Surgical Features

                                                                CLINICAL ISSUES

                                                                • Presentation

                                                                  • Demographics

                                                                    • Natural History & Prognosis

                                                                      • Treatment

                                                                        DIAGNOSTIC CHECKLIST

                                                                        • Consider

                                                                          • Image Interpretation Pearls

                                                                            • Reporting Tips

                                                                              Selected References

                                                                              1. Smith MM et al: Pediatric nasal obstruction. Otolaryngol Clin North Am. 51(5):971-85 2018
                                                                              2. Zawawi F et al: The pathogenesis of choanal atresia. JAMA Otolaryngol Head Neck Surg. 144(8):758-59, 2018
                                                                              3. Strychowsky JE et al: To stent or not to stent? a meta-analysis of endonasal congenital bilateral choanal atresia repair. Laryngoscope. 126(1):218-27, 2016
                                                                              4. Gangar M et al: The use of mitomycin C in pediatric airway surgery: does it work? Curr Opin Otolaryngol Head Neck Surg. 22(6):521-4, 2014
                                                                              5. National Organization for Rare Disorders: CHARGE syndrome. http://rarediseases.org/rare-diseases/charge-syndrome. Reviewed May 27, 2016. Accessed May 27, 2016
                                                                              6. Adil E et al: Congenital nasal obstruction: clinical and radiologic review. Eur J Pediatr. 171(4):641-50, 2012
                                                                              7. Aslan S et al: Comparison of nasal region dimensions in bilateral choanal atresia patients and normal controls: a computed tomographic analysis with clinical implications. Int J Pediatr Otorhinolaryngol. 73(2):329-35, 2009
                                                                              8. Burrow TA et al: Characterization of congenital anomalies in individuals with choanal atresia. Arch Otolaryngol Head Neck Surg. 135(6):543-7, 2009
                                                                              9. Corrales CE et al: Choanal atresia: current concepts and controversies. Curr Opin Otolaryngol Head Neck Surg. 17(6):466-70, 2009
                                                                              10. Ramsden JD et al: Choanal atresia and choanal stenosis. Otolaryngol Clin North Am. 42(2):339-52, x, 2009
                                                                              11. Hengerer AS et al: Choanal atresia: embryologic analysis and evolution of treatment, a 30-year experience. Laryngoscope. 118(5):862-6, 2008
                                                                              12. Samadi DS et al: Choanal atresia: a twenty-year review of medical comorbidities and surgical outcomes. Laryngoscope. 113(2):254-8, 2003
                                                                              13. Vanzieleghem BD et al: Imaging studies in the diagnostic workup of neonatal nasal obstruction. J Comput Assist Tomogr. 25(4):540-9, 2001
                                                                              14. Behar PM et al: Paranasal sinus development and choanal atresia. Arch Otolaryngol Head Neck Surg. 126(2):155-7, 2000
                                                                              15. Keller JL et al: Choanal atresia, CHARGE association, and congenital nasal stenosis. Otolaryngol Clin North Am. 33(6):1343-51, viii, 2000
                                                                              16. Black CM et al: Potential pitfalls in the work-up and diagnosis of choanal atresia. AJNR Am J Neuroradiol. 19(2):326-9, 1998
                                                                              17. Slovis TL et al: Choanal atresia: precise CT evaluation. Radiology. 155(2):345-8, 1985