未治療で経過した先天性後鼻孔閉鎖例

抄録

A young girl, 5 years and 9 months of age, was referred to our hospital because of nasal obstruction, mouth breathing and coughing at night. At 6 years of age, reconstructive surgery for the treatment of bilateral choanal atresia was performed using a transnasal approach. Airway tubes were retained in each choanae for 4 months after the surgery. Reobstruction of both choanae was not recognized until two years after the surgery. Nasal obstruction and mouth breathing had improved, but mouth breathing sometimes occurred unconsciously. The patient was able to recognize strong smells, but could not identify what the smells were. It is generally agreed that bilateral choanal atresia in the newborn with dyspnea is an emergency situation. This patient evidently did not experience dyspnea and survived without surgery because she was able to breathe orally since newborn. Considering that the patient's problems, such as nasal obstruction and disturbances of the sense of smell had been prolonged, surgical treatment for bilateral choanal atresia was recommended as soon as possible. This paper comprises a discussion of clinical symptoms in a case of untreated congenital choanal atresia.