Causes and clinical manifestations of atresia of the choanal cavity of the nasal cavity

The choanae are also called internal nostrils and are small openings along the back wall of the nasal cavity that connect the nasal cavity to the pharynx. The choanae serve as conduits for air to the upper respiratory tract. When the nasal choanae are closed, it is very difficult for infants, in whom nasal breathing predominates. Choanal atresia can be congenital or acquired. Infection of the choanae manifests itself already at an early age, congenital atresia is diagnosed immediately after birth.

Why is the choana in the nasal cavity overgrown? Causes of choanal atresia

The causes of congenital infection of the choanae are associated with a violation of the processes of embryonic development in the first months of pregnancy. There is an interruption or delay in the process of separation of the nasal cavity from the pharynx. Initially, the nose is separated from the pharynx by a mesenchymal membrane, which later dissolves, leaving openings - the nasal passages. If this process is disturbed, the mesenchymal tissue is either replaced by bone tissue or is preserved, which leads to atresia of the nasal choanae.

Such a violation of intrauterine development may be due to chronic diseases of the mother (diabetes mellitus, pyelonephritis, bronchial asthma), infections during pregnancy (flu, chlamydia, measles, rubella, mycoplasmosis, toxoplasmosis) and taking drugs with a teratogenic effect (antibiotics , barbiturates).

Acquired choanal atresia occurs after serious injuries or burns during the formation of a connective tissue scar. The transferred purulent - inflammatory process can also be resolved by infection of the nasal choanae.

When and how does choanal atresia appear?

The most dangerous is congenital complete choanal atresia, because a newborn child breathes only through his nose. When the choanae become infected, the only way for air to reach the child is a cry. Thus, a newborn child quickly develops hypoxia and respiratory failure, which can have a different outcome.

Partial infection of the choanae leads to chronic hypoxia, which negatively affects the formation of the facial skeleton, the growth of teeth, the child lags behind in mental development. In adults, unilateral choanal atresia is often observed. This is manifested by a violation of nasal breathing in one half of the nose, a decrease in smell, and the periodic separation of a large amount of opaque and thick mucus from the nose. Mucus accumulates with choanal obstruction, collects at the back of the nose with the formation of a lump. The outflow of mucus occurs when the patient's head is tilted. Nasal voice appears with bilateral choanal fusion.

Diagnosis and treatment of choanal atresia in the nasal cavity

Complete choanal atresia is detected immediately after the birth of a child, partial infection is detected later, depending on the severity of respiratory failure. The main method for diagnosing choanal atresia is probing the nasal cavity. When probing, the probe inserted into the nasal cavity does not pass into the pharynx, but rests against some kind of dense formation that overlaps the posterior wall of the nasal cavity.

Diagnosis can be confirmed by a lateral skull x-ray taken after injection of a radiopaque solution into the nasal cavity. During rhinoscopy, patients have dry mucous membranes and atrophic changes in it. Sometimes a shortening of the nasal concha and atrophy of the nasal conchas are detected. The nasal septum is deviated to the side with unilateral fusion of the choanae, with bilateral it is in the middle. It is necessary to differentiate choanal atresia with a foreign body in the nasal cavity, benign tumors and traumatic injuries of the nose.

Choanal atresia is treated surgically. The indication for urgent surgery is complete congenital choanal atresia.