Choanal Atresia

  • Eimear PhelanEmail author
  • John Russell
Reference work entry


Choanal atresia or stenosis is the most common craniofacial defect of the nose. In choanal atresia there is either partial or complete obstruction of the one or both openings (posterior choanae) connecting the nasal cavity to the pharynx. Bilateral choanal atresia presents at birth with life-threatening airway obstruction, as neonates are obligate nasal breathers. The etiology of choanal atresia is largely unknown. Infants with bilateral choanal atresia will require stabilization of their airway soon after birth. Surgical repair should be performed early in bilateral choanal atresia if there are no medical contraindications.


Choanal atresia Choanal stenosis Airway obstruction 


  1. Barbero P, Valdez R, Rodriguez H, et al. Choanal atresia associated with maternal hyperthyroidism treated with methimazole: a case control study. Am J Med Genet A. 2008;146:2390–5.CrossRefGoogle Scholar
  2. Bedwell JR, Choi SS. Are stents necessary after choanal atresia repair? Laryngoscope. 2012;122:2365–6.CrossRefGoogle Scholar
  3. Brown OE, Pownell P, Manning SC. Choanal atresia: a new anatomic classification and clinical management applications. Laryngoscope. 1996;106:97–101.CrossRefGoogle Scholar
  4. Burrow TA, Saal HM, de Alarcon A, et al. Characterization of congenital anomalies in individuals with choanal atresia. Arch Otolaryngol Head Neck Surg. 2009;135:543–7.CrossRefGoogle Scholar
  5. Clementi M, Di Gianantonio E, Cassina M, et al. Treatment of hyperthyroidism in pregnancy and birth defects. J Clin Endocrinol Metab. 2010;95:E337–41.CrossRefGoogle Scholar
  6. Dedo HH. Transnasal mucosal flap rotation technique for the repair of bilateral choanal atresia. Otolaryngol Head Neck Surg. 2001;124:674–82.CrossRefGoogle Scholar
  7. Eladl M, Khafagy YW. Endoscopic bilateral congenital choanal atresia repair of 112 cases, evolving concept and technical experience. Int J Pediatr Otorhinolaryngol. 2016;85:40–5.CrossRefGoogle Scholar
  8. Freng A. Congenital choanal atresia: etiology, morphology and diagnosis in 82 cases. Scand J Plast Reconstr Surg. 1978a;12(3):261–5.CrossRefGoogle Scholar
  9. Freng A. Growth in width of the dental arches after partial extirpation of the mid palatal suture in man. Scand J Plast Reconstr Surg. 1978b;12:267–72.CrossRefGoogle Scholar
  10. Harris J, Robert E, Källén B. Epidemiology of choanal atresia with special reference to the CHARGE association. Pediatrics. 1997;99(3):363–7.CrossRefGoogle Scholar
  11. Hasegawa M, Oku T, Tanaka H, et al. Evaluation of CT in the diagnosis of congenital choanal atresia. J Laryngol Otol. 1983;97:1013–5.CrossRefGoogle Scholar
  12. Hengerer AS, Brickman TM, Jeyakumar A. Choanal atresia: embryologic analysis and evolution of treatment, a 30-year experience. Laryngoscope. 2008;118:862–6.CrossRefGoogle Scholar
  13. Ibrahim AA, Magdy EA, Hassab MH. Endoscopic choanoplasty without stenting for congenital choanal atresia repair. Int J Pediatr Otorhinolaryngol. 2010;74:144–50.CrossRefGoogle Scholar
  14. Keller JL, Kacker A. Choanal atresia, CHARGE association and congenital nasal stenosis. Otolaryngol Clin North Am. 2000;33:1343–51.CrossRefGoogle Scholar
  15. Kubba H, Bennett A, Bailey CM. An update on choanal atresia surgery at Great Ormond Street Hospital for children: preliminary results with mitomycin C and KTP laser. Int J Paediatr Otorhinolaryngol. 2004;68:939–45.CrossRefGoogle Scholar
  16. Kwong KM. Current updates on choanal atresia. Front Pediatr. 2015;3:52.CrossRefGoogle Scholar
  17. Lee LJ, Canfield MA, Hashmi SS, et al. Association between thyroxine levels at birth and choanal atresia or stenosis among infants in Texas, 2004–2007. Birth Defects Res A Clin Mol Teratol. 2012;94(11):951–4.CrossRefGoogle Scholar
  18. Nour YA, Foad H. Swinging door flap technique for endoscopic transeptal repair of bilateral choanal atresia. Eur Arch Otorhinolaryngol. 2008;265:1341–7.CrossRefGoogle Scholar
  19. Ramsden JD, Campisi P, Forte V. Choanal atresia and choanal stenosis. Otolaryngol Clin North Am. 2009;42:339–52.CrossRefGoogle Scholar
  20. Samadi DS, Shah UK, Handier SD. Choanal atresia: a twenty year review of medical comorbidities and surgical outcomes. Laryngoscope. 2003;113:254–8.CrossRefGoogle Scholar
  21. Schoem SR. Transnasal endoscopic repair of choanal atresia: why stent? Otolaryngol Head Neck Surg. 2004;131:362–6.CrossRefGoogle Scholar
  22. Strychowsky JE, Kawai K, Moritz E, Rahbar R, Adil EA. To stent or not to stent? A meta-analysis of endonasal congenital bilateral choanal atresia repair. Laryngoscope. 2016;126(1):218–27.CrossRefGoogle Scholar
  23. Teissier N, Kaguelidou F, Couloigner V, et al. Predictive factors for success after transnasal endoscopic treatment of choanal atresia. Arch Otolaryngol Head Neck Surg. 2008;134:57–61.CrossRefGoogle Scholar
  24. Van Den Abbeele T, Francois M, Narcy P. Transnasal endoscopic treatment of choanal atresia without prolonged stenting. Arch Otolaryngol Head Neck Surg. 2002;128:936–40.CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2020

Authors and Affiliations

  1. 1.Our Lady’s Children’s Hospital CrumlinDublinIreland

Personalised recommendations