Bilateral congenital choanal atresia encountered in late adulthood

Abstract

To our knowledge, this is the oldest patient with bilateral congenital choanal atresia to be reported in the recent literature. This condition is rarely encountered in adulthood but should be considered as a possible differential diagnosis of persistent nasal obstruction.

Conservative management of bilateral choanal atresia? Bilateral choanal atresia diagnosed in a 5-year-old girl

“…The comprising tissue may be bony or membranous 2 3. with a preponderance for mixed composition,3 however, it has also been suggested that with improving imaging technology it is becoming apparent that the vast majority, if not all, cases have some form of bony occlusion 5.…”

“…While there are cases in the literature of patients diagnosed with BCA in adulthood 1 2. these have predominantly been in developing nations where access to healthcare is less available and lower priority symptoms such as nasal discharge and mouth breathing may be less likely to receive the same extent of investigation as those in developed nations.…”

“…The presentation of unilateral CA commonly occurs at a later age than those children affected by bilateral CA (BCA) and can often persist undiagnosed into adulthood 1. BCA, on the other hand, typically presents with respiratory obstruction within the first few days of life, or desaturations with or without cyanosis when feeding or during exertion 2. This is due to the obligate nasal airway of the neonate and as such the deformity is almost uniformly diagnosed within the first few days to weeks of life 2.…”

“…BCA, on the other hand, typically presents with respiratory obstruction within the first few days of life, or desaturations with or without cyanosis when feeding or during exertion 2. This is due to the obligate nasal airway of the neonate and as such the deformity is almost uniformly diagnosed within the first few days to weeks of life 2. CA may be suspected in the clinical setting with an inability to pass nasogastric tubing and is almost invariably confirmed on CT imaging 3–5.…”

Comprehensive management of congenital choanal atresia

“…In case of bilateral atresia, the ability at birth to breath spontaneously through the mouth depends on the species. Although primates, among them humans, are obligatory nasal breathers [2], there are a few reported cases who survived many years despite total nasal blockage due to bilateral CCA [5][6][7].…”