A 3-day-old neonate presents with respiratory distress and cyanosis during feeding that resolves when crying. Nasal catheter cannot be passed beyond 3 cm from the nares. What is the most common anatomical type of this condition, and which associated syndrome should be ruled out?

• A Bony atresia (most common); rule out CHARGE syndrome
• B Mixed bony-membranous atresia (most common); rule out CHARGE syndrome ✓
• C Membranous atresia (most common); rule out Treacher Collins syndrome
• D Cartilaginous atresia (most common); rule out Pierre Robin sequence

Explanation

Choanal atresia is most commonly mixed bony-membranous in type (two-thirds of cases), while purely bony forms are less common. Bilateral choanal atresia presents in neonates with cyclical cyanosis during feeding and relief on crying (obligate nasal breathers). CHARGE syndrome must be ruled out. The diagnosis is confirmed by inability to pass a catheter beyond 3 cm and CT showing a bony or membranous plate at the posterior choana.

Reference: Cummings Otolaryngology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.