http://drtbalu.co/index.php?action=history&feed=atom&title=An_incidental_case_of_bilateral_choanal_atresia 2026-04-11T23:59:17Z Revision history for this page on the wiki MediaWiki 1.34.1 http://drtbalu.co/index.php?title=An_incidental_case_of_bilateral_choanal_atresia&diff=816&oldid=prev 2018-10-29T10:53:39Z

<p>Created page with &quot; <a href="/index.php/Category:Case_Report" title="Category:Case Report">Category:Case Report</a> === Patient history: === 18 years old male Bilateral nasal obstruction since childhood ++ Right sided nasal discharge since childhood ++ === Cl...&quot;</p> <p><b>New page</b></p><div><br /> <br /> [[Category:Case Report]]<br /> <br /> === Patient history: ===<br /> <br /> 18 years old male<br /> <br /> Bilateral nasal obstruction since childhood ++<br /> <br /> Right sided nasal discharge since childhood ++<br /> <br /> === Clinical examination: ===<br /> <br /> Deviated septum to left ++<br /> <br /> Right inferior turbinate hypertrophy ++<br /> <br /> === Imaging: ===<br /> <br /> CT scan PNS plain coronal cuts showed:<br /> <br /> DNS<br /> <br /> Rt inferior turbinate hypertrophy<br /> <br /> There was no evidence of sinusitis<br /> <br /> Choanal atresia could not be made out ? missed out in the cuts i.e. 5 mm cuts<br /> <br /> === DNE showed: ===<br /> <br /> DSL with inferior turbinate hypertrophy<br /> <br /> Choanal atresia on both sides<br /> <br /> <br /> [[File:Ca 1.jpg|framed|center|Endoscopic examination]]<br /> <br /> === Treatment: ===<br /> <br /> Septal correction with transnasal repair of choanal atresia was performed<br /> Atretic bony plate was drilled out and the recreated choana was stented.<br /> <br /> === Post op management: ===<br /> <br /> Stent was left in place for 6 weeks.<br /> <br /> Regular nasal douching and suction clearance was done.<br /> <br /> <br /> ===Discussion:===<br /> <br /> During the third week of IU life the nasal placodes starts to invaginate forming nasal pits.<br /> <br /> These pits burrow into the surrounding mesenchyme forming nasal pouches.<br /> <br /> Formation of bucconasal membrane occurs at this point.<br /> <br /> === Pathogenesis: ===<br /> <br /> Choanal atresia could be caused by persistent bucconasal membrane / faulty mesodermal migration.<br /> <br /> Boundaries of atretic plate:<br /> <br /> Superior - sphenoid<br /> <br /> Lateral - Medial pterygoid lamina<br /> <br /> Medial - vomer<br /> <br /> Inferior - Horizontal plate of palatine bone<br /> <br /> CT scan features suggestive of choanal atresia:<br /> <br /> === Choanal air space measurement: ===<br /> <br /> Mean normal - 0.67<br /> <br /> Mixed atresia - 1/3 of normal<br /> <br /> Bony atresia - 0<br /> <br /> Mean width of vomer:<br /> <br /> Mean - 0.23<br /> <br /> Bony atresia - 0.6<br /> <br /> Membranous atresia -0.3<br /> <br /> <br /> [[File:Ca 2.jpg|framed|center|CT scan showing choanal atresia]]<br /> <br /> <br /> === Possible surgical approaches: ===<br /> <br /> Transnasal<br /> <br /> Transpalatal<br /> <br /> Trans septal<br /> <br /> Syndromes associated with choanal atresia:<br /> <br /> CHARGE<br /> <br /> Treacher Collins<br /> <br /> Crouzans</div>

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