Choanal Atresia

Condition Description

Choanal atresia is a narrowing or blockage of the nasal airway by tissue. It is a life-threatening congenital condition, meaning it is present at birth. This obstruction fails to rupture when it typically does during fetal development. The cause of choanal atresia is unknown. Females get this condition about twice as often as males. When only one nostril is affected (unilateral atresia) it will typically be the right nostril. Twice as many babies are born with only one nostril affected (unilateral) as with both nostrils obstructed (bilateral choanal atresia). More than half of affected infants also have other congenital problems.

Babies are "obligate nose breathers", meaning that they can only breathe through their noses; the only time newborns breathe through their mouths is when they are crying. Babies with bilateral choanal atresia (both nostrils affected) will have severe respiratory distress (trouble breathing) in the newborn period with cyclical cyanosis (periods of their skin turning grey/blue due to lack of oxygen). This is because when they are crying they will be able to exchange air by mouth-breathing. However, when they close their mouths to suck, they will not be able to breath. If only one nasal passage is obstructed this condition might not be detected for months or years.

The condition is the most common nasal abnormality in newborn infants, affecting about 1 in 7,000 live births. 

Using data from Minnesota births between 2014-2018, we found 39 babies were born with choanal atresia, resulting in a rate of 1.2 babies per 10,000 births. Annually, about 8 babies were born with choanal atresia. 

Parental education and support are essential, and local, regional, and national organizations may be very helpful.

Condition specific organizations

• Children's Choanal Atresia Foundation
• Medline Plus: Choanal Atresia