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Head and Neck
Diagnosis
Nose and Sinus
Congenital Lesions
Choanal Atresia
Choanal Atresia
Bernadette L. Koch, MD; Surjith Vattoth, MD, FRCR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Definitions

                • Congenital obstruction of posterior nasal aperture
                  • 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

                        • Staging, Grading, & Classification

                          • Gross Pathologic & Surgical Features

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Consider

                                      • Image Interpretation Pearls

                                        • Reporting Tips

                                          Selected References

                                          1. Koppen T et al: Diagnostics and therapy of bilateral choanal atresia in association with CHARGE syndrome. J Neonatal Perinatal Med. 14(1):67-74, 2021
                                          2. Qin Z et al: Clinical and genetic analysis of CHD7 expands the genotype and phenotype of CHARGE syndrome. Front Genet. 11:592, 2020
                                          3. Moreddu E et al: International Pediatric Otolaryngology Group (IPOG) consensus recommendations: diagnosis, pre-operative, operative and post-operative pediatric choanal atresia care. Int J Pediatr Otorhinolaryngol. 123:151-15, 2019
                                          4. Albdah A et al: Choanal atresia repair in pediatric patients: is the use of stents recommended? Cureus. 11(3):e4206, 2019
                                          5. Moreddu E et al: Prognostic factors and management of patients with choanal atresia. J Pediatr. 204:234-9.e1, 2019
                                          6. Smith MM et al: Pediatric nasal obstruction. Otolaryngol Clin North Am. 51(5):971-85 2018
                                          7. Zawawi F et al: The pathogenesis of choanal atresia. JAMA Otolaryngol Head Neck Surg. 144(8):758-59, 2018
                                          8. 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
                                          9. National Organization for Rare Disorders: CHARGE syndrome. Reviewed May 27, 2016. Accessed May 27, 2016. http://rarediseases.org/rare-diseases/charge-syndrome
                                          10. Adil E et al: Congenital nasal obstruction: clinical and radiologic review. Eur J Pediatr. 171(4):641-50, 2012
                                          11. 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
                                          12. Burrow TA et al: Characterization of congenital anomalies in individuals with choanal atresia. Arch Otolaryngol Head Neck Surg. 135(6):543-7, 2009
                                          13. Corrales CE et al: Choanal atresia: current concepts and controversies. Curr Opin Otolaryngol Head Neck Surg. 17(6):466-70, 2009
                                          14. Ramsden JD et al: Choanal atresia and choanal stenosis. Otolaryngol Clin North Am. 42(2):339-52, x, 2009
                                          15. Hengerer AS et al: Choanal atresia: embryologic analysis and evolution of treatment, a 30-year experience. Laryngoscope. 118(5):862-6, 2008
                                          16. Keller JL et al: Choanal atresia, CHARGE association, and congenital nasal stenosis. Otolaryngol Clin North Am. 33(6):1343-51, viii, 2000
                                          17. Black CM et al: Potential pitfalls in the work-up and diagnosis of choanal atresia. AJNR Am J Neuroradiol. 19(2):326-9, 1998
                                          18. 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 aperture
                                                          • 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

                                                                • Staging, Grading, & Classification

                                                                  • Gross Pathologic & Surgical Features

                                                                    CLINICAL ISSUES

                                                                    • Presentation

                                                                      • Demographics

                                                                        • Natural History & Prognosis

                                                                          • Treatment

                                                                            DIAGNOSTIC CHECKLIST

                                                                            • Consider

                                                                              • Image Interpretation Pearls

                                                                                • Reporting Tips

                                                                                  Selected References

                                                                                  1. Koppen T et al: Diagnostics and therapy of bilateral choanal atresia in association with CHARGE syndrome. J Neonatal Perinatal Med. 14(1):67-74, 2021
                                                                                  2. Qin Z et al: Clinical and genetic analysis of CHD7 expands the genotype and phenotype of CHARGE syndrome. Front Genet. 11:592, 2020
                                                                                  3. Moreddu E et al: International Pediatric Otolaryngology Group (IPOG) consensus recommendations: diagnosis, pre-operative, operative and post-operative pediatric choanal atresia care. Int J Pediatr Otorhinolaryngol. 123:151-15, 2019
                                                                                  4. Albdah A et al: Choanal atresia repair in pediatric patients: is the use of stents recommended? Cureus. 11(3):e4206, 2019
                                                                                  5. Moreddu E et al: Prognostic factors and management of patients with choanal atresia. J Pediatr. 204:234-9.e1, 2019
                                                                                  6. Smith MM et al: Pediatric nasal obstruction. Otolaryngol Clin North Am. 51(5):971-85 2018
                                                                                  7. Zawawi F et al: The pathogenesis of choanal atresia. JAMA Otolaryngol Head Neck Surg. 144(8):758-59, 2018
                                                                                  8. 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
                                                                                  9. National Organization for Rare Disorders: CHARGE syndrome. Reviewed May 27, 2016. Accessed May 27, 2016. http://rarediseases.org/rare-diseases/charge-syndrome
                                                                                  10. Adil E et al: Congenital nasal obstruction: clinical and radiologic review. Eur J Pediatr. 171(4):641-50, 2012
                                                                                  11. 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
                                                                                  12. Burrow TA et al: Characterization of congenital anomalies in individuals with choanal atresia. Arch Otolaryngol Head Neck Surg. 135(6):543-7, 2009
                                                                                  13. Corrales CE et al: Choanal atresia: current concepts and controversies. Curr Opin Otolaryngol Head Neck Surg. 17(6):466-70, 2009
                                                                                  14. Ramsden JD et al: Choanal atresia and choanal stenosis. Otolaryngol Clin North Am. 42(2):339-52, x, 2009
                                                                                  15. Hengerer AS et al: Choanal atresia: embryologic analysis and evolution of treatment, a 30-year experience. Laryngoscope. 118(5):862-6, 2008
                                                                                  16. Keller JL et al: Choanal atresia, CHARGE association, and congenital nasal stenosis. Otolaryngol Clin North Am. 33(6):1343-51, viii, 2000
                                                                                  17. Black CM et al: Potential pitfalls in the work-up and diagnosis of choanal atresia. AJNR Am J Neuroradiol. 19(2):326-9, 1998
                                                                                  18. Slovis TL et al: Choanal atresia: precise CT evaluation. Radiology. 155(2):345-8, 1985