آترزي كوآن دوطرفه در يك نوزاد: گزارش موردي

NEONATAL BILATERAL CHOANAL ATRESIA: A CASE REPORT

Choanal atresia is the most common congenital anomally of the nose and has a frequency of aproximately 117000 live births. It consists of a unilateral or bilateral bony (29%) or bonymembranous(71%) wall. Nearly 50% of affected infants have other congenital anomalies or CHARGE syndrome that include: coloboma, heart disease, choanal atresia, growth and development retardation, CNS anomalies, genitalia anomalies, hypogonadism or both, ear anomalies or deafness. Clinical manifestations: When only one side is affected, the infant usually dose not have severe symptoms at birth and maybe asymptomatic for a prolonged period, often untile the first respiratory infections. In bilateral atresia, they have cyanosis and respiratory problem with sucking that relieved with srying. Diagnosis: inability to pass a firm catheter through each nostril more than 3-4 cm into the nasopharynx. The atresia plate maybe seen directly with fberoptic rhinoscopy. The anatomy is best visualized by using CTscan of the nasopharynx. Treatment of choanal atresia depends on the severity of the obstruction and clinical presentation of the infant. Unilateral atresia rarely requiers surgical intervention durin infancy and is usually corrected before school bcgins(4-5 years old). In bilateral atresia, if an oral airway is tolerated by the infant, surgical correstion is best delfered until the infant reach to the 4th-6th week of age or more than 4kg. In CHARGEʹ syndrome. tracheosotomy may preferable to immediate repair, depending on the severity of the associated anomalies. In this article, a newborn present with bilateral choanal atresia, that after birth had cynosis. General examination, heart and pulmonary examination were normal. In nasal examination a catheter could not pass through each nostril more than 3 cm and with bilateral choanal atresis diagnosis was operated. After operation, the infant hospitalized in intensive care unit and had been under conservation treatment. After 3 weeks, the infant discharged with good condition.