Clinical features
Unilateral choanal atresia usually presents late as unilateral nasal discharge and nasal blockage.
Bilateral choanal atresia is life threatening; newborn babies are obligate nose breathers and have a very strong urge for nasal breathing even when the nose is totally obstructed. They usually present at birth with respiratory distress. Frequently they are cyanosed when they are not crying - crying is the only time a neonate mouth breaths.
Clinically the diagnosis can be made by failure to pass a nasogastric tube.
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