Presentation
Healthy baby with failure to pass a catheter through the right nasal cavity
Patient Data
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Narrowed right posterior choanal opening (measures 2.5 mm) compared to the left side (measures 5 mm) secondary to medial bowing of the posterior maxilla and thickened vomer. The right nasal cavity is seen obliterated with a plug of retained secretions. Normal aeration of the left nasal cavity and left-sided nasal septal deviation.
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The red arrow points to the right choanal atresia. The green arrow points to the normal left side. The orange circle surrounds the thickened vomer.
Case Discussion
Congenital choanal atresia is unilateral in two-thirds of cases. It is osseous in 90% of cases and membranous in 10%. Our case is of osseous type with retained secretions. Unilateral choanal atresia presents late and can be asymptomatic or present with rhinorrhea.