What is unilateral choanal atresia?
Choanal atresia (say: co-ANN-ul ah-TREE-zee-ah) is a condition in which the back of the nasal passage is blocked by bone or soft tissue. The nasal passage is the route that brings air through the nose to the throat. Choanal atresia is present at birth.
In unilateral choanal atresia, only one side of the nasal passage is blocked. The baby can still breathe through the side that is not blocked.
Your child will need surgery to open the nasal passage
A child with unilateral choanal atresia will need surgery (an operation) to open the nasal passage. This surgery can wait until the child is older. An otolaryngologist/head and neck surgeon (ear, nose and throat doctor) will perform the surgery.
This page explains what to expect when your child is having surgery for unilateral choanal atresia and how to take care of your child after the operation.
Getting ready for the operation
Several hours before the operation, your child will need to stop eating and drinking. The doctor or nurse will tell you when your child must stop eating and drinking.
Important information
Date and time of the operation:
When you must stop feeding your child:
Other things to remember:
Your child's otolaryngology (ENT) doctor:
The doctor's phone number:
The otolaryngology (ENT) clinic nurse's number:
Your family doctor's number:
What happens during the operation
Before the operation starts, your child will have a special "sleep medicine" called a general anaesthetic. This means your child will sleep through the operation and will not feel any pain.
During surgery, the nasal passage is opened. A small plastic tube called a nasal stent is placed in the nostril to keep the nasal passage open while it is healing.
The surgery usually takes from one to two hours.
After the operation
You will be able to see your child as soon as they are fully awake. A volunteer from the surgical waiting room will bring you to see your child.
After the operation, your child will spend at least one hour in the recovery room, also called the Post-Anaesthetic Care Unit (PACU). Your child will then be transferred to a room on the Otolaryngology (ENT) inpatient unit. Nurses will monitor your child to make sure they are recovering well after the operation.
- Your child will be on a monitor that helps the nurse watch their breathing.
- Your child will have an intravenous (IV) tube in their arm until they are drinking and no longer needs IV medication.
- If your child has pain, the doctor or nurse will give them pain medicine, either through the IV tube or as a liquid to swallow.
- Your child will be able to drink sips of clear fluids and can eat soft foods when they are ready.
- When your child is fully awake, they will be able to get up to go to the washroom or sit in a chair with your help.
- Your child may have some pinkish/red fluid called mucus coming from their nostril. If the mucus is thick, the nurses will suction it with a thin plastic tube called a catheter tip.
- A nurse will show you how to put nose drops in the nostril that has the stent in it.
- You may sleep overnight in your child's room.
Your child will likely be in the hospital for one to three days.
Caring for your child at home
Follow these intructions when your child goes home after the procedure.
You may give your child medicine for pain
You may receive a prescription for pain medication, before you leave the hospital. Follow the dosage instructions given to you by the pharmacist. Although these prescription pain medications can be beneficial, they are also potentially very dangerous if not used properly.
When using these medications, if you notice any changes in either breathing or level of drowsiness that concern you, stop the medication and seek medical attention. If your child is unresponsive, call 911 immediately.
Do not give your child over-the-counter medicine that may have a sedative effect (makes people sleep) while giving the prescription pain medicine. Examples of these medicines are decongestants and antihistamines. Discuss these medications with your pharmacist.
You may give your child acetaminophen if they have pain. Give the dose as printed on the bottle for your child's age. Do not give your child ibuprofen or acetylsalicylic acid (ASA) for two weeks after the surgery. These medications could increase your child's risk of bleeding after the operation. Check with the nurse or doctor first before giving these medicines to your child.
Give your child nose drops
Your child's nurse will give you a prescription for antibiotic nose drops before you leave the hospital. Remember to place the drops into the nasal passage around the stent. Do not put the drops in the stent.
Meals at home
Once at home, keep giving your child fluids (such as juice and soup) and soft food. If they are able to tolerate this well, they can go back to eating what they normally eat.
Bathing
Your child can have baths. Make sure to keep the nasal stent clear of tub water.
Help your child breathe more comfortably
You can use a machine called a humidifier to help your child breathe more comfortably. A humidifier makes the air moist by creating a cool mist. This helps keep the mucus in your child's nasal stent loose, so it does not become sticky and block the stent. Put it at your child's bedside.
Activity
Check with the otolaryngology doctor before your child starts playing sports or swimming, or goes back to school or day care.
When to see the doctor after the procedure
Your otolaryngology doctor will tell you when they will need to see your child again. The otolaryngology unit will tell you the date and time for a follow-up appointment.
Your child will probably need to wear the nasal stent for about three months. When your child is ready, the stent will be removed in the hospital under a general anaesthetic.
When to call the doctor
Please call your child's otolaryngology doctor, otolaryngology clinic or family doctor right away if your child has any of the following signs after going home:
- yellowish or green nasal discharge
- bleeding from the nose or mouth
- fever of 38.5°C (101°F) or higher
- the stent falls out
- pain that gets worse
- vomiting (throwing up) that does not stop
- swelling of the nose or face
- trouble swallowing
- trouble breathing
If this is an emergency, do not wait. Take your child to the closest emergency department.