A neonate with bilateral choanal atresia may present with signs of asphyxia. Neonates are obligate nasal breathers, so significant nasal obstruction can cause significant problems.


Clinical features of bilateral choanal atresia:

(1) evidence of airway obstruction soon after birth

(2) stridor

(3) paradoxical cyanosis (the neonate becomes pink when crying)

(4) low oxygen saturation with cyanosis when not crying

(5) evidence of obstruction to the nasal airways

(6) exclusion of other causes of airway obstruction


The presence of other malformations may indicate the presence of the CHARGE syndrome.


Bilateral choanal atresia must be distinguished from other causes of nasal obstruction.


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