Challenge: What's the diagnosis?
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Monday, August 27, 2012
Sniff
A newborn girl presents in the first few days of life with upper airway obstruction and noisy breathing. On feeding, she becomes cyanotic, which resolves when she cries. To help, you try to place a nasal trumpet to relieve obstruction but cannot advance the 6 French catheter. An oral airway helps the obstruction until definitive surgery can occur. CT is shown below.
Challenge: What's the diagnosis?
Image shown under Fair Use.
Challenge: What's the diagnosis?
Image shown under Fair Use.
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choanal atresia
Choanal atresia.The cause of choanal atresia is unknown. It is thought to occur when the thin tissue separating the nose and mouth area during fetal development remains after birtSymptoms
Newborns generally prefer to breathe through their nose. Typically, infants only mouth breathe when they cry. Babies with choanal atresia have difficulty breathing unless they are crying.
Choanal atresia may affect one or both sides of the nasal airway. Choanal atresia blocking both sides (bilateral) of the nose causes acute breathing problems with cyanosis and breathing failure. Infants with bilateral choanal atresia may need resuscitation at delivery. More than half of infants have a blockage on only one side, which causes less severe problems.
Symptoms include:
Chest retracts unless the child is breathing through mouth or crying
Difficulty breathing following birth, which may result in cyanosis (bluish discoloration), unless infant is crying
Inability to nurse and breathe at same time
Inability to pass a catheter through each side of the nose into the throat
Persistent one-sided nasal blocka
Choanal atresia!
Choanal atresia?
yes...nice answers..thanks for the detail elnaz boki.
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Sniff
This is choanal atresia, the obliteration or blockage of the posterior nasal aperture. It is often associated with bony abnormalities of the pterygoid plates and midfacial growth anormalities. CT shows narrowing of the posterior nasal cavity at the level of pterygoid plate.
Source: UpToDate.
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