Choanal atresia: Symptoms, causes, diagnosis, treatment and prevention (1) - PowerPoint PPT Presentation

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Choanal atresia: Symptoms, causes, diagnosis, treatment and prevention (1)

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Choanal atresia is a rare condition that affects babies. It is a congenital defect that affects respiratory function and caused by blockage of the choana, which is a passageway, that connects each side of the nose to the throat. – PowerPoint PPT presentation

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Title: Choanal atresia: Symptoms, causes, diagnosis, treatment and prevention (1)


1
Choanal Atresia
2
Choanal Atresia
  • Choanal atresia is a rare condition that affects
    babies. It is a congenital defect that
    affects respiratory function and caused by
    blockage of the choana, which is a passageway,
    that connects each side of the nose to the
    throat. These passageways are essential for
    breathing through the nose. This is problematic
    in infants, as babies cannot breathe very easily
    through the nose for at least a few months after
    birth. The condition may be present as an
    isolated birth defect in a baby that is otherwise
    healthy or it could also be part of a genetic
    disorder called CHARGE syndrome that affects
    various organs and bodily functions. The blockage
    develops as a result of abnormal bone or tissue
    that obstructs the passageways. Fortunately,
    choanal atresia is a rare condition, affecting
    just one out of every ten thousand newborns. The
    condition can affect one or both nasal passages
    and the blockage may be partial or complete.
    There are two types of choanal atresia Unilateral
    Choanal Atresia and Bilateral Choanal Atresia.

3
Causes of Choanal Atresia
  • The causes of choanal atresia are not clearly
    understood but it may have some connection with
    genetic factors and heredity. The condition is
    caused when recanalization of the nasal fosse
    does not occur during foetal development. Under
    normal circumstances, there is a thin tissue
    membrane towards the back of the nasal airway,
    which separates the nasal passages and the mouth
    area in the foetus. In case of choanal atresia,
    this separating tissue remains through the course
    of foetal development causing a narrowing or
    blockage of the nasal airways, which becomes
    problematic at the time of birth. Although
    there are few known risk factors, there is
    suspicion that both genetic and environmental
    triggers may be involved.

4
Causes of Choanal Atresia
Continue
  • With regard to environmental triggers, certain
    studies have validated these suspicions as in the
    case of an epidemiological study in 2012 that
    showed a higher incidence of choanal atresia
    among women living in regions where there was a
    high presence of atrazine, a chemical compound
    used in herbicides in the region. Other studies
    since then have also suggested a similar link
    with second hand smoke, excessive coffee
    consumption and the intake of certain
    anti-infective urinary tract medications.

5
Symptoms
  • Symptoms of choanal atresia will obviously
    depend on the type of choanal atresia that is
    affecting the child. Unilateral choanal atresia
    will only cause mild symptoms if any and the
    symptoms will usually go unnoticed, as there is
    no immediate risk posed to the baby. Bilateral
    choanal atresia on the other hand can cause
    severe symptoms that can be life threatening.
    Symptoms of choanal atresia include the
    following 
  • Noisy and laboured breathing
  • Difficulty feeding
  • Cyclic respiratory distress which is only
    relieved with crying as this allows the baby to
    breathe orally
  • Nasal drainage
  • Breathing failure upon delivery that necessitates
    resuscitation. (In such a scenario, emergency
    surgery is necessary)

6
Diagnosis of Choanal Atresia
  • In many cases health care providers will arrive
    at their diagnosis pretty swiftly, especially if
    there is difficulty inserting a nasal catheter.
    Doctors will also suspect choanal atresia in the
    event of cyanosis during breast feeding, as nasal
    respiration is essential while feeding. If any
    symptoms arouse suspicion, whether life
    threatening or not, health care providers will
    recommend certain tests to confirm the diagnosis.
    A physical examination will also suffice at times
    as it could reveal nasal obstruction. Tests that
    can help in the diagnosis of choanal atresia
    include the following 
  • Sinus X-rays
  • Nasal Endoscopy
  • CT Scans

7
Treatments
  • In cases where the blockage is severe, causing
    extreme respiratory difficulties, emergency
    medical care will be necessary. Doctors will
    first make efforts to resuscitate the baby if
    necessary and they may need to make an airway to
    enable the infant to breathe. Procedures like
    intubation or tracheotomy could be required. If
    the infant learns to breathe orally, surgery may
    not be required as urgently and can be delayed
    for a while. Whether the surgery is conducted
    immediately or after some delay, it can help to
    cure the condition. Treatment depends on the
    severity of the condition. In mild cases where
    there is no significant respiratory distress or
    feeding difficulty treatment could include the
    following 

8
Treatments
Continue
  • The condition may be managed by keeping the baby
    under close observation and providing him with
    supplemental oxygen periodically.
  • To keep the nasal passages clear of discharge and
    prevent any further impediments to nasal
    breathing, nasal saline may be administered to
    keep the nasal linings healthy.
  • Parents can opt to delay surgical correction of
    the nasal structure until the child is older.
  • In severe cases, where there is a life
    threatening risk, usually because of bilateral
    choanal atresia, there is no room for delays in
    treatment. Treatment in such cases will involve
    evaluation of the patient for any other
    anomalies. Once the patient is stable, surgery
    should be performed immediately.

9
Prevention of Choanal Atresia
  • The risk factors of choanal atresia cannot
    really be avoided, as we still do not have a
    clear understanding about the causes of the
    condition. We can do little about genetic
    factors, which may contribute to the problem.
    Certain environmental allergens or triggers have
    also been identified as being possible risk
    factors in the recent past, and in light of these
    findings, it would be a good idea to avoid or
    reduce exposure to the following
    during pregnancy 
  • Atrazine, a chemical compound present in certain
    herbicides
  • Excessive coffee consumption
  • Zinc and B-12 supplements
  • Some anti-infective urinary tract medications

10
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