Cadd Brandon, Talwar Rishi, Bajaj Yogesh
Department of ENT, Barts Health NHS Trust, London, UK.
BMJ Case Rep. 2014 May 5;2014:bcr2014204455. doi: 10.1136/bcr-2014-204455.
Choanal atresia (CA) is an obliteration or blockage of the posterior nasal aperture, limiting or obstructing the nasal airway to the nasopharynx. 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. 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 and traditional teaching is that this is a life-threatening emergency. We present the case of a 5-year-old girl referred to our department with nasal obstruction, snoring and some mild rhinorrhoea. After investigation she was found to have a mixed bony and membranous BCA and no other craniofacial abnormalities. The BCA was subsequently repaired using urethral dilators and a drill and the child is currently asymptomatic of any restenosis. This case prompts discussion of the various presentations and options in management of CA as well as allowing us an opportunity to discuss the literature on the subject.
后鼻孔闭锁（CA）是后鼻孔的闭塞或阻塞，限制或阻碍了通向鼻咽的鼻气道。单侧CA的症状通常比双侧CA（BCA）患儿出现得晚，且常常在未被诊断的情况下持续到成年。另一方面，BCA通常在出生后的头几天就出现呼吸阻塞，或在喂食或运动时出现血氧饱和度下降，伴有或不伴有发绀，传统观点认为这是一种危及生命的紧急情况。我们报告了一例5岁女孩，因鼻塞、打鼾和轻度鼻漏转诊至我科。经过检查，发现她患有混合性骨膜性BCA，且无其他颅面异常。随后使用尿道扩张器和钻头修复了BCA，该患儿目前没有任何再狭窄的症状。这个病例引发了关于CA的各种表现和治疗选择的讨论，也让我们有机会讨论该主题的文献。
