Which finding is highly suggestive of choanal atresia in a newborn?

Which finding is highly suggestive of choanal atresia in a newborn?

• A. Inability to pass a nasogastric tube through the pharynx
• B. Nasal airway obstruction treated with suction
• C. Bilateral ear malformation
• D. Persistent coughing with feeds

Answer: (A)

Choanal atresia blocks the posterior nasal passages, so a newborn who mainly breathes through the nose often shows an inability to pass a nasogastric tube through the nose into the pharynx. This inability to advance the tube is a classic, highly suggestive sign because it directly reflects the blockage at the back of the nasal cavity. In newborns, especially with bilateral obstruction, this causes immediate respiratory distress since they rely on nasal breathing. Other findings like nasal obstruction needing suction, ear malformations, or coughing with feeds are not as specific to choanal atresia.

Choanal atresia blocks the posterior nasal passages, so a newborn who mainly breathes through the nose often shows an inability to pass a nasogastric tube through the nose into the pharynx. This inability to advance the tube is a classic, highly suggestive sign because it directly reflects the blockage at the back of the nasal cavity. In newborns, especially with bilateral obstruction, this causes immediate respiratory distress since they rely on nasal breathing. Other findings like nasal obstruction needing suction, ear malformations, or coughing with feeds are not as specific to choanal atresia.