Unusual presentation of a unilateral choanal atresia in an adult: a case report
Keywords:Unilateral choanal atresia, Adult, Recurrent sinusitis
Choanal atresia is an uncommon congenital abnormality of nasal airway characterised by the complete obliteration of choana. Unilateral choanal atresia is more common as compared to bilateral choanal atresia. A case of unilateral nasal obstruction in an adult which was initially diagnosed as chronic rhinosinusitis and was posted for endoscopic sinus surgery at a secondary referral hospital. Increased nasal bleeding during the surgery led to the surgeon abandoning the procedure and was referred to Mysore Medical College and Research Institute. On detailed evaluation, unilateral choanal atresia of right sided was noted. It was subsequently managed by endoscopic recanalization of the posterior choana. This case of unilateral choanal atresia in an adult is being reported here for the rarity of its presentation. A high level of clinical suspicion is necessary to diagnose such cases and to prevent avoidable complications during routine endoscopic surgeries. Resection of posterior part of nasal septum to create uni-choana negates the need for stenting post-operatively.
Kelvin M. Kwong. Current updates in choanal atresia. Frontiers Paediatrics. 2015;3:52.
Anajar S, Hassnaoui J, Rouadi S, Abada R, Roubal M, Mahtar M. A rare case report of bilateralchoanal atresiain anadult. Int J Surg Case Rep. 2017;37:127-9
Duggal P, Kajol R, Duggal KK. Unilateral choanal atresia presentation in adults. Indian J Otolaryngol Head Neck Surg. 2005;57(4):345-7.
Tan HY, Noor AM, Anuar, Sawali H. Bilateral choanal stenosis in a craniosynostosis child: a case report. Int J Otorhinolaryngol Head Neck Surg. 20195(1):184-6.
Nanda MK, Assa’ad AH. Unilateral choanal atresia in child with recurrent infections. J Allergy Clin Immunol Pract. 2014;2(6):820-1.
Wetmore RF, Mahboubi S. Computed tomography in the evaluation of choanal atresia. Int J Pediatr Otorhinolaryngol. 1986;11:265-7.
Hengerer AS, Brickman TM, Jeyakumar A. Choanal atresia: embryologic analysis and evolution of treatment, a 30-year experience. Laryngoscope. 2008;118(5):862-6.
Ferguson JL, Neel HB 3rd. Choanal atresia: treatment trends in 47 patients over 33 years. Ann Otol Rhinol Laryngol. 1989;98(2):110-2.
Freng A. Growth in width of the dental arches after partial extirpation of the mid-palatal suture in man. Scand J Plast Reconstr Surg. 1978;12(3):267-72.
Brown OE, Pownell P, Manning SC. Choanal atresia: A new anatomic classification and clinical management applications. Laryngoscope. 1996;106:97-101.
Saafan ME. Endoscopic management of congenital bilateral posterior choanal atresia: value of using stents. Eur Arch Otorhinolaryngol. 2013;270:129-34.
Schoem SR. Transnasal endoscopic repair of choanal atresia: Why stent? Otolaryngol Head Neck Surg. 2004;131:362-6.
Ramsden JD, Campisi P, Forte V. Choanal atresia and choanal stenosis. Otolaryngol Clin N Am. 2009;42:339-52.