Abstract
Introduction Choanal atresia (CA) is a challenging surgical problem defined as a failure in the
development of communication between the nasal cavity and nasopharynx.
Objective The objective of this study is to describe computed tomography (CT) findings in cases
with bilateral choanal atresia.
Methods The study involved performing axial and coronal non-contrast CT scanning with 2–3
mm sections on14 neonates that had bilateral CA. We used fiberoptic nasal endoscopy
to confirm the diagnosis. We evaluated coronal CT to study the skull base area in
such neonates.
Results This study included 14 neonates with bilateral CA; with mean age of 7 ± 3.5 days.
Mixed atretic plates were found in 12 (85.7%) cases while two (14.3%) had pure bony
atresia. Isolated CA was detected in 9 cases (64.3%) and 5 (35.7%) cases had associated
anomalies. Coronal CT showed soft tissue density in the nasal cavity that appeared
to extend through an apparent defect in the nasal roof (cribriform plate), falsely
diagnosed by radiologists as associated encephalocele. At the time of surgical repair,
all patients showed thick tenacious mucous secretions in both nasal cavities and revealed
no encephalocele. Nasal roof remained intact in all cases.
Conclusion The thick secretion of bilateral CA could give a false encephalocele appearance on
the CT. It is highly recommended to perform proper suction of the nasal cavity of
suspected CA cases just before CT scanning.
Keywords
choanal atresia - computed tomography - neonate - encephalocele
