Congenital Disorders of the Nose Flashcards
What is the most common congenital anomaly of the nose?
Choanal atresia is the most common congenital anomaly of the nose and occurs in ~1/7,000 newborns.
Define choanal atresia.
The presence of a bony (90%) or membranous (10%) septum between the nose and the pharynx, either unilaterally or bilaterally.
What is CHARGE syndrome?
Coloboma, Heart disease, Atresia choanae, Retardation of growth and development, Genital anomalies, and Ear anomalies/deafness.
What disorder should one suspect in an infant who has respiratory distress that improves with crying and worsens with feeding?
Choanal atresia
How would one diagnose choanal atresia at bedside?
The diagnosis is suggested by the inability to pass a firm catheter through each nostril past a depth of about 3-4 cm.
What imaging study is required for diagnosis of choanal atresia?
CT scan
What consult services should be contacted if an infant is found to have choanal atresia?
ENT, Cardiology, and ophthalmology.
What initial management step should be taken once an infant is found to have choanal atresia?
Ensure that the infant has a secure oral airway that allows the infant to eat and breathe simultaneously. Infants with severe bilateral involvement who can’t breathe effectively by mouth require a tracheotomy until reconstructive surgery can be safely performed.
What rare congenital nasal abnormality can mimic the symptoms of choanal atresia?
Pyriform aperture stenosis.
Name three types of congenital midline nasal masses.
Dermoids, gliomas, and encephaloceles.
If a congenital midline nasal mass is identified in a neonate, what should be the next step in diagnosis/management?
Intracranial extension of any defect increases the risk of recurrent intracranial infections, so high-resolution CT or MRI should be used to evaluate for intracranial involvement. Resection is indicated if intracranial involvement is identified.
