| 词条 | Choanal atresia |
| 释义 |
| name = Choanal atresia | image = Membranoese Choanalatresie beidseits NG - CT axial und coronar - 001 -Annotationen.png | caption = Bilateral membranous choanal atresia in CT scan | pronounce = | field = | synonyms = | symptoms = | complications = | onset = | duration = | types = | causes = | risks = | diagnosis = | differential = | prevention = | treatment = | medication = | prognosis = | frequency = 1 in 8000 live birth | deaths = }}Choanal atresia is a congenital disorder where the back of the nasal passage (choana) is blocked, usually by abnormal bony or soft tissue (membranous) due to failed recanalization of the nasal fossae during fetal development. It was first described by Roederer in 1755.[1] PresentationIt can be unilateral or bilateral.
Associated conditionsSometimes babies born with choanal atresia also have other abnormalities:
Also any condition that causes significant depression of the nasal bridge or midface retraction can be associated with choanal atresia. Examples include the craniosynostosis syndromes such as Crouzon syndrome, Pfeiffer syndrome, Treacher Collins and Antley-Bixler syndrome. Risk factorsVery few risk factors for choanal atresia have been identified. While causes are unknown, both genetic and environmental triggers are suspected.[2] One study suggests that chemicals that act as endocrine disrupters may put an unborn infant at risk. A 2012 epidemiological study looked at atrazine, a commonly used herbicide in the U.S., and found that women who lived in counties in Texas with the highest levels of this chemical being used to treat agricultural crops were 80 times more likely to give birth to infants with choanal atresia or stenosis compared to women who lived in the counties with the lowest levels.[3] Another epidemiological report in 2010 found even higher associations between increased incidents of choanal atresia and exposure to second-hand-smoke, coffee consumption, high maternal zinc and B-12 intake and exposure to anti-infective urinary tract medications.[4] The anti-thyroid medication methimazole has been associated with the development of choanal atresia in rare cases if given during the first trimester of pregnancy. DiagnosisChoanal atresia can be suspected if it is impossible to insert a nasal catheter.[5] Also, if one notices a continuous stream of mucus draining from one or both nostrils, it could be a sign of an atresia. Another common sign is cyanosis in an infant while breast feeding, as breathing is dependent on nasal patency in this situation.[5] Diagnosis is confirmed by radiological imaging, usually CT scan.[5] TreatmentTemporary alleviation can be achieved by inserting an oral airway into the mouth. However, the only definitive treatment is surgery to correct the defect by perforating the atresia to create a nasopharyngeal airway. If the blockage is caused by bone, this is drilled through and stent inserted. The patient has to have this sucked out by an air vacuum machine . And in later life as a teenager or in early twenties the hole will have to be re-drilled larger. A stent may be inserted[6] to keep the newly formed airway patent or repeated dilatation may be performed.[7] In popular cultureIn the movie City of Angels, Dr. Maggie Rice (played by Meg Ryan) correctly diagnoses the cause of a newborn baby's failure to thrive as due to choanal atresia. References1. ^{{Cite journal|title=Bilateral Choanal Atresia: Is it Really a Surgical Emergency?|url=|journal=Indian Journal of Otolaryngology and Head & Neck Surgery|volume=65|pages=205–209|doi=10.1007/s12070-011-0304-9|pmid=24427647|pmc=3738770|via=|year=2013|last1=Kumar|first1=Sunil|last2=Gupta|first2=Sachin|last3=Naglot|first3=Shakuntala|last4=Sahni|first4=J. K.}} 2. ^[https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002608/ Choanol atresia], NIH PubMed Health, August 2011. 3. ^https://www.bcm.edu/news/hematology/study-exposure-herbicide-risk-rare-disorder 4. ^Epidemiology of choanal atresia - the National Birth Defects Prevention Study, Vijaya Kancherla, University of Iowa,2010. 5. ^1 2 [https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002608/ Choanal atresia - PubMed Health] 6. ^{{cite journal |author=Sadek SA |title=Congenital bilateral choanal atresia |journal=Int. J. Pediatr. Otorhinolaryngol. |volume=42 |issue=3 |pages=247–56 |date=January 1998 |pmid=9466228 |doi= 10.1016/S0165-5876(97)00142-0|url=http://linkinghub.elsevier.com/retrieve/pii/S0165-5876(97)00142-0}} 7. ^{{cite journal |vauthors=Gosepath J, Santamaria VE, Lippert BM, Mann WJ |title=Forty-one cases of congenital choanal atresia over 26 years--retrospective analysis of outcome and technique |journal=Rhinology |volume=45 |issue=2 |pages=158–63 |year=2007 |pmid=17708465 |doi=}} External links{{Medical resources| ICD10 = {{ICD10|Q|30|0|q|30}} | ICD9 = {{ICD9|748.0}} | ICDO = | OMIM = 608911 | MedlinePlus = 001642 | eMedicineSubj = ent | eMedicineTopic = 330 | DiseasesDB = 31330 }}{{DEFAULTSORT:Choanal Atresia}} 1 : Congenital disorders of respiratory system |
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