Choanal Atresia: Causes, Symptoms, and Treatment
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Choanal Atresia?
Babies with choanal atresia are cared for by a neonatologist (a newborn baby doctor) and an ear, nose, and throat (ENT) specialist. A pediatrician (a children's doctor) also helps. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is choanal atresia?
Choanal atresia is a narrowing or blockage of the nasal airway by tissue. It is a congenital condition, which means it is present at birth. It is the most common nasal abnormality in newborn babies. Girls get it about twice as often as boys.
Choanal atresia may affect one or both sides of the nasal airway. More than half of babies with it have a blockage on only one side. This causes less severe problems. A blockage on both sides causes serious breathing problems, with bluish skin and breathing failure. These babies may need resuscitation (emergency help with breathing) at delivery.
Symptoms
Newborns generally prefer to breathe through the nose. Babies usually breathe through the mouth only when they cry. A baby with choanal atresia may have trouble breathing unless the baby is crying.
Symptoms include:
- Trouble breathing after birth, which may cause cyanosis (bluish skin) unless the baby is crying.
- A chest that pulls in (retracts) unless the child is breathing through the mouth or crying.
- Not being able to nurse and breathe at the same time.
- A nose where a doctor cannot pass a catheter (a thin tube) through each side into the throat.
- A one-sided nasal blockage or discharge that does not go away.
One-sided choanal atresia may not cause symptoms.
Causes and who gets it
The cause of choanal atresia is unknown. It is thought to happen when thin tissue that separates the nose and mouth area before birth stays in place after birth. More than half of affected babies also have other birth defects.
Choanal atresia is one feature of CHARGE syndrome, a disorder that affects many areas of the body. CHARGE stands for coloboma (a gap or hole in a structure of the eye), heart defects, atresia choanae (another name for choanal atresia), slow growth, genital problems, and ear problems. CHARGE syndrome affects about 1 in 8,500 to 10,000 newborns. Changes in the CHD7 gene cause most cases of CHARGE syndrome. Most cases are new changes in people with no family history of it.
How doctors diagnose it
Choanal atresia is most often found shortly after birth, while the baby is still in the hospital. One-sided choanal atresia may not cause symptoms, so a baby may go home before it is found. A physical exam may show a blocked nose. Tests that may be done include a CT scan (a detailed x-ray picture), an endoscopy of the nose (a look inside the nose with a small camera), and a sinus x-ray.
Treatment
The first concern is to help the baby breathe, if needed. An airway may need to be placed so the baby can breathe. In some cases, a breathing tube may be needed. A baby can learn to breathe through the mouth, which can delay the need for surgery right away.
Surgery to remove the blockage cures the problem. Surgery may be delayed if the baby can manage with mouth breathing. It may be done through the nose (transnasal) or through the mouth (transpalatal).
Full recovery is expected. Possible complications include food or liquid getting into the airway while feeding, breathing that stops, and the area narrowing again after surgery.
When to see a doctor
If your baby has any of the symptoms listed above, talk to your child's health care provider. The child may need to be checked by an ENT specialist. Call 911 or go to the emergency room if a child has trouble or abnormal breathing, or bluish or grey skin.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Such a doctor can check a child with a one-sided blocked nose that does not go away and refer the child to an ENT specialist.
Common questions
Can choanal atresia be cured?
Yes, surgery to remove the blockage cures the problem. Full recovery is expected, but the area can narrow again after surgery.
Can choanal atresia be prevented?
No, there is no known way to prevent it. The cause is unknown.
Is choanal atresia the same as CHARGE syndrome?
No, choanal atresia is one feature of CHARGE syndrome, which also affects other parts of the body. Many people with CHARGE syndrome have one or both nasal passages narrowed or completely blocked.
Can a baby with choanal atresia breathe?
It depends on whether one or both sides are blocked. A blockage on one side causes less severe problems. A blockage on both sides causes serious breathing problems.
Can choanal atresia be missed at birth?
Yes, it can be missed when only one side is blocked. A baby with a one-sided blockage may go home without a diagnosis.
Sources
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
