How is choanal atresia assessed in infants?

Assessing choanal atresia in infants is best accomplished through the method of alternating nostril occlusion. This technique involves occluding one nostril at a time while observing the infant’s ability to breathe through the other. Infants are obligate nasal breathers, so if one nostril is blocked due to atresia, they will struggle to breathe comfortably. If occlusion of one nostril leads to significant respiratory distress or an inability to breathe, it suggests the presence of choanal atresia in that open nostril.

This assessment is critical as choanal atresia can cause serious respiratory issues if not identified and managed promptly. The other methods, while useful in the assessment of respiratory function, may not provide the specific information needed to identify choanal atresia directly. For example, checking for proper mouth breathing does not differentiate between patent and obstructed nasal passages. Similarly, using a pulse oximeter measures oxygen saturation but does not reveal the mechanics of airflow through the nasal passages. Observing for nasal flaring can indicate respiratory distress but is also non-specific to choanal atresia. Thus, alternating nostril occlusion is the most direct method for assessing this condition in infants.