Unilateral choanal atresia masquerading as chronic sinusitis

Choanal atresia is a congenital anomaly usually diagnosed at birth. This case involves bilateral choanal atresia in a newborn with respiratory difficulties in whom there is an inability to pass a 8 French catheter through the nose. In contrast, unilateral choanal atresia causes a variable degree of nasal obstruction that may delay the diagnosis. We report a case of unilateral choanal atresia in a 9-year-old boy diagnosed as having chronic sinusitis with allergic rhinitus. Initial interpretation of a computerized, tomographic (CT) examination confirmed the diagnosis of chronic sinusitis. The definitive diagnosis, however, was made by endoscopic evaluation. A review is presented of the epidemiology, clinical presentation, differential diagnosis, and contemporary surgical management for unilateral choanal atresia.